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Dealing with grief

Loss or grief is something we will all have to go through at some point, and as GPs it's something we regularly support individuals and families through. Whilst every situation varies greatly, they are all desperately sad. Our local community in York has been struck by two terrible tragedies in the past three months, the loss of two vibrant young lives, and it’s compounded by the lack of opportunity to get together and support each other physically – hugging, crying together, sharing food together and the warmth of hospitality indoors. Other forms of regular contact that we rely on to provide a welcome diversion are also still on hold, our choir, our sporting activities, in-person contact in the workplace, and socialising out of work at weekends and in the evenings.

How we each respond to bad news and grief is different. And that’s okay. It’s okay to feel nothing or an overwhelming ‘everything’. It’s okay to cry or not cry, to feel anger, confusion, disbelief, injustice, yearning, a hideous void, and a thirst for answers or reasons when there may be none. It’s okay to throw yourself into work or a project if you feel able to concentrate and be productive; sometimes the distraction is helpful. It’s also okay to feel moments of joy, and nobody should feel guilty for doing so. And it’s okay to want to talk, or to crave silence and space to reflect.

Nobody is judging.

Nobody is expecting anything.

Now is absolutely the time to lean on friends and family, and if anyone offers a shoulder or a meal or to do your washing, go for it. Do the terribly un-British thing, and accept that practical help. Though we really aren’t great at admitting we have emotions, and conceding that help would actually be really rather nice, are we?

Emotions. As usual it’s down to your amazing and mind-bogglingly complex brain as to how and why we feel anything. Much of it is actually very poorly understood, so extra points to the brain for being so stubbornly unfathomable. Well, there are three areas that are chiefly involved, and we’ll start with the amygdala, which has the cutest name (‘almond’ in Latin, to reflect its little oval shape). This gives us motivation and fear, as well as being involved in learning. A friend of mine bangs a metal pot when putting out food for her kitten, so that now even when out on the prowl he still comes back on hearing his dinner gong, knowing that it’s time for some kitty chow. This is a great example of the ‘conditioned learning’ that Ivan Pavlov and his famous and very well-behaved dogs demonstrated so beautifully in the 19th century. And that’s the amygdala in action folks.

Next we have the insula, which we believe is responsible for feeling of disgust – like if you smell food that’s clearly on the turn. Or stinky wet PE kit. The only downside of schools going back, right?

And finally there’s the periaqueductal grey matter (PAG), a name which conjures up all sorts of images of a grand Hogwarts-esque bridge but really is just a tiny hunkering-down sort of area at the bottom of the brain, that does lots of exciting things including suppressing pain. You know when people annoyingly say “mind over matter”? This is it. Deep breathing, positive imagery, and relaxation before a blood test; all these techniques might actually influence the PAG and help us feel pain less.

That's enough anatomy today, friends. What I really want to say is, if you’ve experienced loss of a loved family member, friend, or pet, please seek help. Call your friendly GP and we will be glad to chat to you, and signpost to other sources of professional support. We don’t always have the solutions, but we are always happy to listen and we are never too busy, we would never consider it being a ‘bother’, and we are never too overwhelmed with COVID; every single call is truly important to that person in that moment and that means it’s important to us too.

And if you are in crisis or know someone who is, please please urge them to get help. York’s Crisis team are available 24/7 on 0300 0200 317.

As well as your local GP, there are some wonderful organisations that are ready to help you:

Cruse - a dedicated free service for bereavement (still offering telephone support during COVID), call them on 01904 481162.

Young Minds - text YM to 85258 if you're experiencing a mental health crisis.

Winston's Wish - a free national helpline 08088 020 021, they also offer text-based support and have a nice website for children who have been bereaved.

Kooth - an online chat based support service for young people (aged 11-24) up to 10pm daily. This is really popular with school-age youngsters who maybe feel more at ease typing than they do talking.

York Menfulness - I love these guys. They provide excellent local support network for men, whose mental health issues are often underrepresented and may be less likely to seek help.

St Leonard's Hospice - our amazing local hospice runs a bereavement support group for people aged 18+ and it's open to anyone, regardless of whether you had any links with the hospice or not. Phone them on 01904 777772 for immediate acute bereavement support, or 708553 for ongoing longer-term support.

Now, please find someone to hug today if you can. And maybe you could be the person that offers to help, or to chat, or to listen, or to do an extra load of washing; you never know it might just be exactly what’s wanted.

dedicated to lovely Jeremy and his family

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