Grief: It’s a journey

Loss is a part of everyone’s life. It comes in different forms, such as, the passing on of a loved one, repossession of our material belongings, loss of status or relationships ending. How do these losses impact on us? How does the taking away of things we hold dear, things that function as extensions of ourselves affect our sense of self? Working in the field of trauma, loss has become a common concept that I grapple with each day. In trauma literature it is often said that trauma ‘shatters’. It shatters the way one looks at and thinks about the world, others and self. With that shattering, one can also argue comes an additional loss. A loss of a world known, loss of trust and faith in people and most significantly loss of self.

As I reflect, I have lost so much in my young life. Some things I found after many days of searching and some were never regained. The way in which I lost these belongings of mine has been different, as in some cases I did the losing and misplacement; and in other cases, things were taken from me by force, taken without my permission or me even knowing they had been taken. Each time I grieved and hid from the world, because it hurt too much. As a consequence I was not present and never got to be grateful for the people and things that were not gone. I have lost money to carelessness and theft; cell phones and laptop to muggers and burglary; I have lost friends to different locations and time; I have lost family members to life and death; and I have lost boyfriends to betrayals and unrequited love. Each time I thought I would not recover, but I would make more money and find a new boyfriend and so life would go on. For those things and people I have lost forever, slowly I would learn to live without them, even though I still feel the gaps in my life that their presence once filled.

Elisabeth Kubler-Ross in her book titled, ‘Life Lessons’ (2000, p.75) said that “we eventually lose everything we have, yet what ultimately matters can never be lost. Our houses, cars, jobs, and money, our youth and even our loved ones are not ours to keep. But realising this truth does not have to sadden us.” I struggled and still struggle with that statement and I read this book about 10 years ago when I had experienced a loss in which I felt overwhelmed with grief. Searching for some understanding of this feeling following my experience of loss, I searched through different books and came across a British novelist, Clive Staples Lewis, who for me captured that overwhelming feeling of my grief in this way “it feels like being mildly drunk or concussed. There is a sort of invisible blanket between the world and me.” I mean this author captured so much of the grief I felt. He says, “who knew that grief felt like fear”, he continues to talk about the spells where one convinces themselves that they don’t mind the loss; and moments when things make sense, when in the end what you prefer is the agony because it is authentic. The author describes the self-pity and wallowing and laziness that comes with grief and the shame.

When I came across these words, I had lost my grandmother, who was everything to me; my pain was so raw that nothing made sense at all. This loss had split me into thousands of tiny pieces and I did not know how to put myself together. I had lost a sense of self. I was still alive and yet this loss made me feel I had died too. All those emotions and behaviours described by Lewis is what I went through. I don’t know why I felt the sense to write on this subject after all these years, perhaps it was finding Lewis’ book and his words resonating with me, or perhaps it is seeing this kind of loss and grief in and out of my practice. And even though I provide ‘talk therapy’, I know that words cannot capture the loss and grief in the world, others and the self. The feeling of grief and loss is inevitably an experience that is felt and needs to be felt. Another author I came across during my search for comfort and understanding wrote, “It doesn’t interest me what planets are squaring your planet. I want to know if you have touched the centre of your own sorrow, if you have been opened by life’s betrayals or have become shrivelled and closed from fear of further pain. I want to know if you can sit with pain, mine or yours, without moving to hide it, or fade it or fix it.’’ Oriah Montain Dreamer (1995: 35).

It came to me 10 years later that people come and go and we should cherish the moments we have with them. Healing began when I started to remember the good and the bad times that I had with my grandmother, the songs we sang and how we danced to the tune that is life. I am what I am because of her and not only did I find comfort, but I found courage and strength to go on. However, there is something endearing about loss in whatever form it comes, one looks at the ‘what if’s’ or ‘I wish you were here’ moments and even in the ‘they’re not here moments’, still life goes on. I now know that we do not lose things and people all at once, we lose in degrees. I mean, 10 years later I still wish my grandmother’s wisdom on child rearing was around. I am quite certain that I will still lose a lot in my life, because loss is typical of life, but I will not go and hide. I also know that I will be saddened by it, but because of this grief, will in turn forever learn to strive to appreciate each moment I have with the people; time and possessions I have right now. What will you do when loss enters your life?

Written by: Thembisile Masondo

A Community Awaken

As a community practitioner working within previously disadvantaged communities and with vulnerable individuals, I reflect on the current status of the political arena in South Africa and the dependence on political leaders to heal us as a nation. And I wonder if we have forgotten our own power as people, as communities, as families.

I have been working in communities for the past 10 years in CSVR and have experienced a lot of love, laughter, heartache and tears but overall a lot of urge for change and togetherness, operating from a place of resilience.

I have been witness to the untold stories, some traumatising and some healing and this has inspired me to write the following poem: ‘A Community Awaken’, which I share with you below.

This poem touches on the idea of a rainbow nation Nelson Mandela once envisioned. Even though a lot of communities have not healed or received the help to heal from the apartheid era, they are still hopeful and working together for a means to healing.  As a community practitioner I don’t often engage in academic forms of writing, and thus I saw this space fit to at least try and capture the untold stories.

Life in South African communities have untold stories, powerful stories of resilience and perseverance, that we could look to, to find our power to create the change we want to see in years to come…

A Community Awaken

Give me  back my yesterday, I am today,

Standing still in the dusty areas of Mzansi!

Fighting for my freedom,

In the 9 Provinces!

Wakeup – Wakeup.

I am priceless, I might not look pretty

But I give life to the lifeless, hopeless and the forgotten

Looking at you from afar feels like I’m miles away from You!

Wakeup – Wakeup.

Mothers, Fathers, Children; South Africans and Non-Nationals

Together we celebrate your breath

The Spirit of living and walking in the noisy street

I enjoy the enchantment of Ubuntu, Laughter and Love

A CommUnity Awaken!

Wakeup – Wakeup.

Sorrow and Tears may come but they don’t stay forever

Service Protest, Killings are part of the daily living

But I don’t get discourage by these trivial events

We will heal in Time!

Wakeup – Wakeup.

The outcome of having life and joy,

Celebrations and ululations is the order of our days

I have drunk all your passion, devotion and Living unity

Move outside the tangle of Fear-thinking!

            Wakeup – Wakeup.

You who has produced lots of teachers

Doctors, nurses, community practitioners and lots of professions

You Making a Difference: Engage – Inspire – Empower!

        CommUnity Awaken…!

By Tsamme Mfundisi

Sitting with the wonderful and the tragic within us

‘Strike the women and you strike the rock’-I recall hearing these words as a young girl when I accompanied my mother at marches against women abuse in the 90’s. I think back to those days surrounded by social workers chanting ‘strike the women and you strike the rock’, wondering what the statement meant and wondering where it came from. Years later I discovered that it was the words of female activists who marched to the Union Building in Pretoria on August, 9, 1956, calling for an end to the pass laws and advocating for women’s rights in South Africa. Winnie Madikizela Mandela, echoed these words in 1966 as she continued to fight for women’s rights. It is words that have become synonymous with the fight against women abuse. Growing up in post-apartheid, I didn’t know much about this South African icon and apartheid activist. All I knew was, she was the president’s wife, and amazed that she waited for him for 27 years to be released. They looked so happy to be reunited on the day of his release on February, 11, 1990. Like the nation I found myself in awe of their love story and commitment to one another. She was the First Lady, until she was no more.

Winnie Madikizela Mandela has been a controversial figure in South African history. With the release of her memoires, interviews, telling of her life story in film and book, we get a glimpse into this controversial figure, her career as a social worker, her marriage to Nelson Mandela, her own experiences of torture at the hands of officials during the apartheid regime and how that shaped and impacted the activist role she took on in the ANC. Quotes from her that come to mind with regard to this is:

“There is no longer anything I can fear. There is nothing the government has not done to me. There isn’t any pain I haven’t known.”
– 1987

“I am the product of the masses of my country and the product of my enemy.”
– 1996

The reason these quotes stick out for me is primarily related to the work that I do with torture survivors. Doing this work over the past 4 years has opened me to a new understanding of what pain, humiliation, isolation and torture can do to the human spirit. As we hold in mind Winnie the activist, the leader, the icon, the First Lady, we also need to hold in mind Winnie the person, the human being, who was tortured whilst imprisoned, the mother, who was separated from her children, unable to provide for them at times as she could not continue her work duties as a social worker. What did this do to the person, what hatred and pain did it ignite. I am by no means condoning the violence that she has been associated with, by no means minimizing the violent actions committed by her and in her name during the struggle, that have followed her through the years. I believe that violence is never the answer to our pain and our hatred, as violence begets violence and the pain and hatred continue in spaces, times and generations. This is evident as we reflect on our country and the manner in which violence continues to be a prominent feature to survive, exert power or simply be heard.

As I write this piece a few days after her death, I really felt compelled, compelled to reflect on this dynamic and rather complex women. And I urge the reader to understand these as my personal reflections and nothing more.

Over the years, as I learnt more about her, I always found myself holding two parts: one part, the strength of this women, the endurance, the love; the other part, is one of a leader that has lost her path, a women hurt, broken, angry. It is only in working with torture survivors that I have become able to hold the parts as a whole and not as polar opposites to each other. She was all the above and more. In conversations about her with people, I found it interesting that they either held the one part or the other, she was either praised or not. This made me think about how symbolic both Winnie and Mandela have been to us a nation.

Winnie is symbolic of the parts of us as a nation that may be uncomfortable, the parts of us that are hurt by injustices such as #LifeEsidimeni, unfairness such as social inequalities #feesmustfall #youthunemployment, poor service delivery #xenophobicattacks #violentprotests. The part of us that is not held, whose grievances and pain are not acknowledged and only through violence we feel impact is made, feel voices are heard. And as a society we shun the violence and ignore the pain. Make payments as a form of reparation then expect it to go away. As I reflect on Winnie being symbolic of the parts of ourselves as a nation that we may struggle to own. Mandela symbolizes the other part of us as a nation, a symbol of peace, forgiveness and hope. We held on to the idea of a rainbow nation, it was beautiful, it was inspirational. But what about those who were not ready, were too hurt, the memories of trauma too recent? Did we suppress those that didn’t agree, and in turn suppress feelings of anger and pain as a nation, until it reached a point of un-containment and spilling out. News headlines in the last few years in South Africa is testimony to this spilling.

As we end the era of Zuma and enter into a new era with Cyril Ramaphosa, I wonder if the leaders of our nation are ready to hold the nation as a whole, will the hopeful and the discontented be sitting at the same table and be heard and understood. Or do we once again, mark those who bring the uncomfortable sides of us out to the side, only to have the pain and discontent play out as it has been doing? Will we continue to suppress those that make us feel uncomfortable, because they force us to face the pain, or will we acknowledge that to heal pain must be felt?

Written by Sumaiya Mohamed

‘Mental health the Cinderella of health care’- President of the South African Federation for Mental Health

I recently attended the 5^th Global Mental Health Summit in Johannesburg, South Africa, which looked at mental health issues on a global scale. Many similarities across continents were noted, such as; the lack of awareness around mental health issues, the stigma that continues to surround mental illness, the increase of mental health concerns amongst the youth and the lack of resources.

It was truly an awe inspiring event, as professionals from various disciplines came together, echoing the World Health Organisation’s (WHO) slogan: “there is not health without mental health”. The presentation given by Crick Lund (Professor and Director at the Alan J Fisher Centre for Public Health, University of Cape Town) stands out for me in particular, as he highlighted the importance of including the role of persons with lived experience in shaping and informing mental health research, to in turn inform policy and strengthen mental health systems. To me this spoke not only to the formulation of policy but also to informing interventions and practices, as these voices are often lost, forgotten or dismissed. This rings true in the #LifeEsidimeniTragedy, with the deaths of mental health patients, who had no say in where they were going to be moved and whose family members could not advocate for them. What happened to human rights? What’s the purpose of having policies such as the Mental Health Policy if we fail to refer to it when implementing? As stated by Dr Lochandra Naidoo (President of the South African Federation for Mental Health), ‘Mental health is the Cinderella of health care’. The forgotten child? The imaginary friend? If not seen, does not matter and if they don’t matter, we can do what we want with them?

This de-valuing of individuals that have a mental illness can be explored in relation to how we have been socialized into understanding mentally ill individuals and mental illness as a whole. As my mother often would say to me, to understand the present you have to go back to the beginning. Pre 16^th Century, mental illness was attributed to the supernatural, witchcraft and insanity simply meant possession by the devil. By the 16^th Century, individuals with psychological disorders were seen as dangerous and needed to be locked away to protect society. By the 17^th Century, the mentally ill could participate with society but still needed to be understood as ‘mad’. With the term ‘lunatics’ becoming more common in reference to the mentally ill, who were also considered weak, in the 18^th Century. Thus, from this brief history, we can see how we may have been socialized to perceiving the mentally ill as less and mental illness as something that makes one incapable of participating in society and not the norm. If you have a mental illness, there must be something horribly wrong with you. By the 19^th and 20^th Century things started to change, as punitive treatments were abolished, an investment was made in understanding mental health as a health issue, which led to research being done to understand the causes of mental illness and in turn the establishment of more appropriate treatments and most importantly protecting the human rights of the mentally ill was emphasized.

So we have made progress over the years. Yet a stigma around mental illness still exist in the fabric of our societies. More needs to be done clearly, but what does this more look like? Dr Lochandra Naidoo calls for the creation of a ‘society in which mental health receives the attention it deserves’. I fully agree with this statement and to be honest I was shocked that mental health was not getting the attention it deserves. But as I reflected on this, I came to the realization that as a mental health practitioner, I engage with mental health issues on a daily basis, moreover, I studied it for 7 years, so I got a good base when it comes to understanding it in the context of myself, the family, community and broader society I live in. But, not everyone has this background. And even though in South Africa, we have been advocating, raising awareness and campaigning about mental health and illness, there’s a gap. And I say there’s a gap because I do believe that our government is a microcosm of the broader society. And the treatment by the government of mentally ill individuals in the Life Esidimeni tragedy speaks to an overall lack of understanding of mental health and mental health care. A disregard for the one of the most vulnerable groups in our society.  We have come a long way, but clearly, still have a long way to go.

I invite you to share your thoughts on the way forward, how do we create a society in which mental health receives the attention it needs?

Written by: Sumaiya Mohamed

 

‘An empty stomach has no ears’…..What do your ethics say?

‘An empty stomach has no ears’ is an African phrase commonly used by clients within our context. Referring to a hungry person not being able to concentrate on anything else, except their need to get their basic needs met. Many times as clinicians we sit and contemplate the contextual realities of many of our clients. My client has nowhere to live, another has no job, there’s no money for school fees and ones that can’t even afford food for their children. In sitting with these things an overwhelming sense of helplessness can become all consuming (which is often an echoing of the helplessness the individual is feeling about their situation). When I first started I used to have immense feelings of guilt and sadness, really just wanting to be able to give my client money to get food for her children. But that goes against two important aspects of my training, the first being to empower the individual to be able to do this for themselves and secondly that my professional ethical code of conduct prohibits it. Rationally being able to understand why I couldn’t did not help with the feelings. I eventually found myself switching off to it and constantly telling myself that that is not my role as a therapist. But my training also told me that you cannot do therapy with a hungry person and that can at times be so present in the therapy room that no amount of rationalisation can make it feel better.

Then we start coming towards the end of the year, which to me means Christmas time and holiday. Things that my socioeconomic status allows me to look forward to, but it is also a time where I reflect on the many things that I have in my life. So this year as the clinic we decided to try something a little bit different. We know that we cannot really give our clients things directly but technically that does not stop us from getting things donated. Some may have heard of the Santa shoe-box initiative whereby people can sponsor a child and pack a shoe-box with some essential toiletries, stationery, a toy and clothing. So we decided to do one for the children of the clients that we see at the trauma clinic. This was done specifically because many parents are often filled with sadness at not being able to give their children anything over the Christmas period and that the beginning of the year is often filled with such stress at getting basic stationery for the children old enough to go to school. Initially once we put together the list of children the task began to seem a bit overwhelming and I doubted the ability to get everything together and ensure that all the children got something. But truly sometimes the universe aligns itself and hears what is needed and the people that were approached began offering to help and helped in abundance of what was requested of them. And as a result 60 children’s Santa shoe-boxes were donated and given in December. Of course, this did not meet the greater basic needs of clients and perhaps it just met my own need to do something about my own levels of despair regarding client’s contextual realities.

What this also really speaks to the ethical dilemma that many individuals may face when working in impoverished settings, the professional ethics of what one is supposed to do and the human ethics of what one wants to do as a human being for another and this constant tug of war between the two. So before we begin to feel completely shut off to this aspect of others it was worthwhile seeing what could be done in the confines of what we could do. Being mindful of the reality that one small parcel does not solve the hunger that will be in the therapy room with me in the next session.

Written by Jacqui Chowles