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

Comment

Politics

7 May 2025

4 min read

Assisted dying is not a medical procedure; it is a social one

Another vote, and an age-related amendment, highlight the complex community of care.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

Graffiti reads 'I miss me' with u crossed out under the 'mem'

Sidd Inban on Unsplash.

Scottish Parliament’s Assisted Dying bill will go to a stage one vote on Tuesday 13th May, with some amendments having been made in response to public and political consultation. This includes the age of eligibility, originally proposed as 16 years. In the new draft of the bill, those requesting assistance to die must be at least 18.

MSPs have been given a free vote on this bill, which means they can follow their consciences. Clearly, amongst those who support it, there is a hope that raising the age threshold will calm the troubled consciences of some who are threatening to oppose. When asked if this age amendment was a response to weakening support, The Times reports that one “seasoned parliamentarian” (unnamed) agreed, and commented:

“The age thing was always there to be traded, a tactical retreat.”

The callousness of this language chills me. Whilst it is well known that politics is more of an art than a science, there are moments when our parliamentarians literally hold matters of life and death in their hands. How can someone speak of such matters as if they are bargaining chips or military manoeuvres? But my discomfort aside, there is a certain truth in what this unnamed strategist says.

When Liam McArthur MSP was first proposed the bill, he already suggested that the age limit would be a point of debate, accepting that there were “persuasive” arguments for raising it to 18. Fortunately, McArthur’s language choices were more appropriate to the subject matter. “The rationale for opting for 16 was because of that being the age of capacity for making medical decisions,” he said, but at the same time he acknowledged that in other countries where similar assisted dying laws are already in operation, the age limit is typically 18.

McArthur correctly observes that at 16 years old young people are considered legally competent to consent to medical procedures without needing the permission of a parent or guardian. But surely there is a difference, at a fundamental level, between consenting to a medical procedure that is designed to improve or extend one’s life and consenting to a medical procedure that will end it?

Viewed philosophically, it would seem to me that Assisted Dying is actually not a medical procedure at all, but a social one. This claim is best illustrated by considering one of the key arguments given for protecting 16- and 17- year-olds from being allowed to make this decision, which is the risk of coercion. The adolescent brain is highly social; therefore, some argue, a young person might be particularly sensitive to the burden that their terminal illness is placing on loved ones. Or worse, socially motivated young people may be particularly vulnerable to pressure from exhausted care givers, applied subtly and behind closed doors.

Whilst 16- and 17- year-olds are considered to have legal capacity, guidance for medical staff already indicates that under 18s should be strongly advised to seek parent or guardian advice before consenting to any decision that would have major consequences. Nothing gets more major than consenting to die, but sadly, some observe, we cannot be sure that a parent or guardian’s advice in that moment will be always in the young person’s best interests. All of this discussion implies that we know we are not asking young people to make just a medical decision that impacts their own body, but a social one that impacts multiple people in their wider networks.

For me, this further raises the question of why 18 is even considered to be a suitable age threshold. If anything, the more ‘adult’ one gets, the more one realises one’s place in the world is part of a complex web of relationships with friends and family, in which one is not the centre. Typically, the more we grow up, the more we respect our parents, because we begin to learn that other people’s care of us has come at a cost to themselves. This is bound to affect how we feel about needing other people’s care in the case of disabling and degenerative illness. Could it even be argued that the risk of feeling socially pressured to end one’s life early actually increases with age? Indeed, there is as much concern about this bill leaving the elderly vulnerable to coercion as there is for young people, not to mention disabled adults. As MSP Pam Duncan-Glancey (a wheelchair-user) observes, “Many people with disabilities feel that they don’t get the right to live, never mind the right to die.”

There is just a fundamental flawed logic to equating Assisted Dying with a medical procedure; one is about the mode of one’s existence in this world, but the other is about the very fact of it. The more we grow, the more we learn that we exist in communities – communities in which sometimes we are the care giver and sometimes we are the cared for. The legalisation of Assisted Dying will impact our communities in ways which cannot be undone, but none of that is accounted for if Assisted Dying is construed as nothing more than a medical choice.

As our parliamentarians prepare to vote, I pray that they really will listen to their consciences. This is one of those moments when our elected leaders literally hold matters of life and death in their hands. Now is not the time for ‘tactical’ moves that might simply sweep the cared-for off of the table, like so many discarded bargaining chips. As MSPs consider making this very fundamental change to the way our communities in Scotland are constituted, they are not debating over the mode of the cared-for’s existence, they are debating their very right to it.