© Priory Lodge Education Ltd., 1998.


Videotape Review:

"No Chance to Say Goodbye"

Traumatic Bereavement and its Management

Producer: David Doepel
Echo Bridge Productions USA

This video deals with the issue of traumatic and sudden bereavement, when death comes without warning, often in the course of as traumatic event, and where there is literally "No chance to say goodbye"

At the beginning of the video we are introduced to four people, who tell their own story in the course of the video, and who all suffered a traumatic bereavement. I have changed their names for the sake of this review on the Internet. Jack's wife was killed in a road accident whilst out jogging; Mary's parents, both old and ill, died in a suicide pact; Mark's daughter was murdered; Elizabeth's husband died suddenly.

During the video we are treated to lucid and often harrowing descriptions of the traumas and their aftermaths, told by the next of kin. In the words of Elizabeth:

During the first year it was just total devastation to begin with - I could just not believe that this thing could possibly have happened as my husband always was a fit man - he never ever complained of any problems of any description - so to just keel over like that within within half an hour of first saying that he didn't feel too well, and actually dying, was so unbelievable that it was a complete blur for a whole year.

Nor must we forget the Medics and Paramedics, usually in the front line of the caring professions in the immediate aftermath of tragedies. In the words of Dr Hugh Millington:

The have got their own feelings to cope with...and coming to terms with their own feelings isn't easy, and then they have got to cope with the relatives who are going to find it much more difficult to come to terms with the suddeness of the death, and the loss of someone who probably left the home in the morning fit and well.

In addition to grief, many suffer the symptoms of Posttraumatic Stress Disorder (PTSD). Colin Murray-Parkes tells us of how the bereaved can often be haunted by resurrent nightmares or intrusive daytime images related to the trauma, together with the hypervigilance ('almost waiting for the next disaster'). Such experiences can be associated with chronic avoidance - avoidance of any triggers which might remind them of the loss. Different people can be affected in different ways. Elizabeth was unable to stay in for two or three years:

Without the help of my friends and everybody around me I am sure I would never have got through it at all...because in the beginning I just never stayed in at all...

Colin Murray-Parkes talks of the special problems with murder or manslaughter:

It is not only the killer who is likely to be blamed - people blame the police, the Government, the legal system, God, the powers that most of the time we take for granted, and feel they can somehow protect us.

Jack still feels a sense of injustice that the driver whose car collided with his wife whilst she was out jogging was not prosecuted. He gives an account of the time he arrived at the scene of the tragedy. Detective Superintendent Peter Whent talks of the importance of having the right person to break the news to to the nearest relative:

One of the first important things is who breaks the news and how to do it...and I have said for some time that we need to select from a supervisor's point of view not the nearest police officer to break the news, but the most appropriate police officer to break the news.

Colin Murray-Parkes reminds us that anger is a normal emotion:

Anger is a perfectly normal part of grieving, and in itself is neither good nor bad - however it can have good or bad consequences according to how it is controlled and expressed...

The counsellor needs to be aware that anger is a sort of wave that will break over them and if they are not going to be hurt by it, and they understand it - then the bereaved person will feel understood and no harm will be done.

Mark talked of his devastation at finding his daugher, although he had the presence of mind to keep his wife away from the scene. There are extra difficulties when the loved one has been murdered; as Peter Whent tells us:

Everybody in a homicide investigation is a suspect, including you, including me, until we are eliminated by the enquiry. Everybody who is in the scene when the police arrive is treated as a potential suspect.

and it is important to prepare the family for what is to come:

What you can do is tell the family what is likely to happen - the types of stories and angles that the press would carry in the newspaper and on television - to prepare them for the next few days particularly because when they leave the house they are likely to have a number of press photographers outside, and a number of press reporters, who will ask for any sort of quote.

Often the family will be excluded from their own house, and from their usual posessions, as it will be sealed off as a scene of crime.

Colin Murray-parkes talks of the special problems when the bereavement has been by suicide. There can be the aggressive suicide, attempting to hurt those who are closest. There is another kind of suicide that occurs when a person has a guilty secret and has been found out; the suicide is an attempt to escape the consequences. Both these varieties of suicide can have an enormous emotional impact on the individual. Peter Whent continues the thread by reminding us that there can be many extra issues in breaking the news, and that they need to be prepared for what might possibly come out in the press in due course.

And then there is the suicide of people who are severely physically ill, and can see no escape. Mary talks in some detail of how she supported her own children through the funeral of their grandparents, so that they could say Goodbye in their own way. Colin Murray-Parkes talks of how there are particular problems for children:

For a child things are likely to be compounded by the way in which adults themselves conceal things from children. We often think that the best way of helping the child is by not talking to it about what has happened, by not inviting the child to funerals, and occasions which are actually upsetting but also opportunities to grieve - and this kind of overprotection actually creates more problems for the child who then feels excluded and rejected...

Towards the end of this video, we are invited to see that often the bereaved to emerge from their tragedies stronger and wiser. In the words of Colin Murray-Parkes:

In a way by expressing grief, by our thoughts and feelings in this way we come through the process of grieving and we actually learn from bereavement about the dark side of life...we may actually emerge from it stronger and wiser than we went in to it..

The final words are from Mark:

....I couldn't be critical of anybody because they didn't know - and I didn't know - and unless victims, people like me are prepared to talk and to tell our stories and to explain how we feel.....and what we feel about the justice system and everything else, nobody is ever going to know. One of my pet little things is that we all bathe in the glory of the Linford Christies and the Olympic Gold Medal holders .....they are all produced by Britain and we are all proud of them - but we also produce monsters - and if we are going to bathe in the glory, we have also got to accept the responsibility that we have produced monsters and we have got to look after the people that these monsters injure.

The video overall was of high technical quality, with good clear sound and sharp closeups of the bereaved men and women. This I feel is important, as they were all expressing more than could be achieved by words alone. They were certainly brave to allow such a disclosure of their inner worlds; hopefully they will, via the video, enable many others to attain greater knowledge and sensitivity.

The video is accompanied by a manual of support notes. Particularly useful are a number of group exercises whose aim is to help the participants learn to understand both the practical and emotional issues involved. There are separate exercises that deal with: the immediate aftermath; the road traffic accident; issues involved with murder and manslaughter; posttraumatic stress disorder; suicide; children and sudden death; implications and sources of help. Also, importantly there is an exercise on the debriefing of police, fire and accident and emergency personnel. There are two further exercises: 'When the dust has settled' and 'the role of community leaders in coping with sudden death in their community'.

There were also a number of useful appendices; particularly useful is a checklist of various personnel who might be involved in the aftermath of a traumatic death.

Verdict ? I would certainly recommend this video, which could be of use in the training not only of healthcare professionals, but also of police, religious leaders, lawyers, victim support service - indeed all of those mentioned in the checklist. The discussions would be particularly interesting and useful in a multidisciplinary or multiagency setting. The video will also be useful for the busy clinician who has little time for the preparation of teaching and discussion material, and will welcome finding that it has been done for him !

Reviewed by
Tony Roberts

Supplied by:

Heathcliff Distribution
PO Box 226 Summer Hill NSW 2130
41 Gould Avenue Petersham NSW 2049
Tel: (02) 550 0801
Fax: (02) 560 2404