This section is from the book "Emotional First Aid: A Crisis Handbook", by Dr. Sean Haldane. Also available from Amazon: Emotional First Aid: A Crisis Handbook.
The face of grief was described by Darwin as having two main features: a turning down of the comers of the mouth, and a slanting downward of the eyebrows obliquely while the centre of the forehead is raised. The expression of forehead and mouth match each other in the turning downward at the edges. We all recognize this. The popular phrase 'down in the mouth' describes it. In crying, the active expression of grief, spasmodic sobs shake the chest and shoulders, and the eyes tend to close tightly as tears are shed. The downward slant of the eyebrows and the corners of the mouth becomes more acute.
Darwin also noted that young infants do not sob, with the characteristic breaks in the outbreath, but instead utter a long unbroken wail. Modern psychologists note that this wail is difficult to distinguish from anger. Its emotional content is essentially a demand for the mother. Broken sobbing seems to begin when the infant becomes aware of the experience of loss: the sound breaks with sadness in the knowledge that the wail may not produce a response. Raging demand and despairing loss both occur in the expression of adult grief.
Where the rage content of crying is high, the expression has a hard quality, and the person may instinctively push away any tender approach from a helper. The energy of the crying is directed quite forcefully outward, and contains long wailing sounds between sobs. In despair, the expression is softer. The sobs do come out, but seemingly from a great depth. They are partly locked up in the abdomen, and the person may be doubled over, 'racked by sobbing.' Outward movement consists of reaching out or clinging with the hands.
Crying mixed with rage is discussed in a later section, Switching. If a switch to outright anger does occur, this demands measures discussed in Chapter 5, on anger.
Despairing crying, 'pure grief,' involves soft convulsions of the body: the chest lets down in breathing out and jerks in spasms that shake the shoulders, as the head is pulled backward and the pelvis tends to jerk forward. If the person is lying down, a more or less fetal position of being curled up occurs. Eventually the discharge of emotion is complete, although it may rebound again into new periods of sobbing that in turn subside, leaving the person fresh and relieved—what we mean by such phrases as 'there's nothing like a good cry.' A good cry leaves the body warm, face flushed, eyes bright, chest and abdomen soft and mobile.
The social expression of crying is clinging. This is ultimately like the clinging of a baby to its mother. Even if the person is alone, he or she will tend to cling to a handkerchief or pillow.
You can test some of the measures that will be discussed in this chapter by applying them to yourself. It is also useful to gain some sense of how the encouragement of the movements that occur in an expression may intensify the feeling that is building up. You can, in fact, artificially induce some of the feelings of grief by imitating it. You might try the following exercises a few times. As you become used to them, the feeling may emerge. They can also be used as self-help measures, if you feel a knot of sadness inside that you want to relieve.
1) If you are sitting down, take your face in your hands, palms against your cheeks and fingers over the eyes, and begin to rock back and forth from the waist, at the same time letting out an 'Ooooooh' sound that continues to the end of each out-breath. Make the outbreath as long as you can, letting your chest collapse inward. You may feel some of the sensations of sorrow, and your chest may begin to make sobbing motions during the outbreath. (If this procedure makes you anxious, take away your hands and look around.)
2) Try to simulate sobbing in whatever way seems suitable to you. In particular, you might lie down on your side in a slightly curled position, imitate the face of grief, and as you breathe out deliberately make your chest jerk by uttering the sound of 'Ah-ha, a-ha, a-ha.' Always breathe out all the way. Act it out, let it be dramatic.
3) Try lying on your back with your knees up and feet flat (a position that frees the abdomen) and looking around the walls of the room for a few minutes, in a lonely, searching way, while letting out deep sighs.
4) In the same position, clutch a cushion tightly against your chest, and sigh out deeply making an 'Oooooh' sound, squeezing your eyelids tight with the outbreath, relaxing them but not opening them on the inbreath.
If you find yourself crying, give in to the feelings, and don't be ashamed. We all have something to cry about.
What happens physically in the full expression of an emotion contains the clues about how the expression may be blocked, whether by a temporary resistance to it or by a longstanding trait of character structure. Since in crying the head moves back in an attitude of surrender, and the chest lets down convulsively, resistance to crying implies a stiffening of the back of the neck and a hardening of the chest in an inflated position. Similarly, the throat may tighten against letting out a sigh (the person may choke back the tears) and the shoulders may be held high and rigid, which prevents any shaking. In many people who have been left to 'cry it out' as infants, or who have hardened themselves against seeming too soft, the abdomen has become hard and tight—a common block against deep feelings that have become too painful or shameful to endure. EFA can help dissolve these resistances and muscular tensions if they are not too deeply ingrained.
Some outward signs of distress that accompany the grief expression when a person is feeling the need to cry but suppressing it are:
—The eyes stare, without making contact, in an expression of despair. (If you know the person well enough to be sure that the pupils are normally mobile, a fixed dilation of the pupils is a sign of anxiety or of impending crying; after crying the pupils regain their mobility.)
—The mouth is clamped shut in an expression of misery, sometimes so forcefully that the lips may pucker or whiten.
—'Freezing.' The body is held stiffly, the chest immobile and inflated. Often some tears in the eyes are the only indication of emotion.
—There is agitation or panic while the grief expression is visible on the face. Sometimes the person will look 'about to burst'—chest inflated, hands tense, shoulders high.
—Rocking the body back and forth over a narrow range may be visible, while the body itself is held immobile and tight.
—The voice becomes low and monotonous, with apparent difficulty in speaking.
As a person begins to cry, signs of blocking are:
—choking sounds, sometimes severe enough to become retching and spluttering.
—hardening and stiffening of chest and neck.
—attempts to hold the breath: the mouth clamped shut, with convulsive swallowing 'bottled in.'
—Dry sobbing. The eyes do not participate. Instead they stare, or if shut, there are no tears.
It is unnecessary to explore (as will be the case with anger and fear) ways to provoke the emotion of grief, since these are obvious—cruelty, withdrawal of support, and so on. But it may be worth noting that efforts to impose an ethic of 'don't cry,' 'be brave,' or 'let's put a brave face on it,' may, paradoxically, provoke an explosion of grief. If you want to test this, you might try sticking your jaw forward defiantly and saying out loud: 'I won't cry, I won't cry.' Chances are you will begin to feel very sad.
The first stage of contact must be through words, but it is advisable to keep them brief. The content will not likely be heard anyway if the person is deeply distressed. The timing of when to speak and make a tentative contract for help is up to you—it depends on how well you know the person, or what the needs of the situation are. If you don't run from the pain of your own concern, and you stay serious, you will find the right thing to say. Simple comments like 'it must really hurt,' or 'you must feel very bad about it,' provided they are not made in a condescending way, may help the emotion spill over. They legitimize and confirm the person's feeling and give a permission, which may be needed, to express it. And there are simple questions or suggestions such as 'Can I help you?', 'Will you let me hold you?' or 'It's O.K. to let it out.'
It is best to restrict your words to simple descriptions of what you see or feel. Forget, for a while, discussion of the content of the person's problem. Even once the person has agreed to let you help, stick to descriptions, even of resistances. 'You're holding yourself so tight; let yourself breathe.'
The person should also be encouraged to express his or her feelings nonverbally. Don't prohibit talk, but suggest alternatives: 'Why not just lie down over here and let go.' Encourage the person to sigh, to make sounds rather than form words.
Finally, if the person refuses your help, take no for an answer. If you are concerned, of course stay around in case you can give physical support such as helping the person into another room, or finding something to drink or a blanket-whatever is necessary. But don't push emotional contact, once it has been refused, unless the person changes his or her mind and asks for it.
 
Continue to: