蘇·歐文-2022 年 6 月 5 日
今天是我的休息日，我有自己的時間，沒有約會，沒有和朋友一起喝咖啡，除了在這裡無處可去，所以我手裡拿著一杯咖啡，走到花園裡，坐下在陽光下。必須檢查我的電子郵件以防萬一，我對自己說，所以拿起我的手機看看那裡有什麼。一家著名的旅遊評論公司告訴我我可能想去的地方——我刪除了。如果我在未來 7 天內與他們一起預訂，機場停車場公司會提供 20% 的折扣 – 我刪除了。然後是來自 Mad in America 的每週通訊，在過去的 12 個月裡，我只是瞥見甚至忽略了（抱歉 MIA），而不是像 Olly 死前那樣徹底閱讀。
It’s my day off work today and I’ve got time to myself, no appointments, no coffee stops with friends and nowhere to be but here, so with a mug of coffee in hand, I make my way out into the garden, and sit down in the sunshine. Must check my emails just in case, I say to myself, so pick up my phone to see what’s there. There’s one from a well-known travel review company telling me about the places I might wish to visit – I delete. There’s another from an airport car parking company offering me a 20% discount if I book with them in the coming 7 days – I delete. And then there’s the weekly newsletter from Mad in America, which, over the past 12 months, I’ve just glimpsed at or even ignored (sorry MIA), rather than read through thoroughly like I used to before Olly died.
不過，今天要改變一下，我發現自己滾動瀏覽文章標題，在頁面下方不遠的地方是“悲傷藥丸來了！”。這是 Donna Shuurman（謝謝 Donna）寫的一篇關於 DSM 新診斷“長期悲傷障礙 (PGD)”的博客的標題，其症狀必須在失去後 6 個月時升高，並且必須與顯著的功能相關損害，以使一個人符合 PGD 標準。
Today for a change though, I find myself scrolling through the article headings and not too far down the page there it is “The Grief Pill is Coming!”. It’s the title of a blog by Donna Shuurman (thank you Donna) writing about the new DSM diagnosis of “Prolonged Grief Disorder (PGD)”, the symptoms of which must be elevated at 6 months post-loss and must be associated with significant functional impairment in order for a person to meet criteria for PGD.
什麼……？他們又來了，我聽到自己默默地說。
What the ….? They’re at it again, I hear myself silently saying.
當我慢慢閱讀假設 PGD 是一種成癮障礙的研究的句子和參考資料時，我注意到一些不舒服但熟悉的感覺在我的身體周圍和通過我的身體湧動，這表明我感到難以置信、絕望和絕對憤怒的混合。
As I slowly read the sentences and references to a study hypothesising that PGD is a disorder of addiction, I notice some uncomfortable but familiar sensations surging around and through my body, signifying that I’m feeling a mix of disbelief, despair and absolute outrage.
尤其是其中的一句話突然出現在我面前，如此敏銳地抓住了我的注意力，以至於感覺很私人。
One sentence in particular jumps out at me and grabs my attention so acutely, that it feels personal.
“診斷的主要門戶症狀是渴望( yearning)；對死者的持續渴望、惦念或全神貫注……這樣，PGD 患者在死後繼續渴望 親人，因為他們對親人的記憶提供了積極的強化”（Gang 等。 2021 年）
“The primary gateway symptom for diagnosis is yearning; persistent longing, pining for, or preoccupation with the deceased…….in this way, patients with PGD continue to crave their loved ones after they have died, due to the positive reinforcement provided by their memories of the loved one” (Gang et. al 2021)
上述研究的作者似乎已經開發了一種篩查工具來診斷這種疾病，當我點擊鏈接查看它時，我的好奇心得到了控制。我只是看看它說了什麼，我對自己說，但我最終打印了文檔並完成了它。哦，我現在非常生氣，12 個月來第一次，我有一種強烈的寫作慾望；渴望寫一篇回應並向這些善意的所謂專家解釋我對他們試圖將高度痛苦和極度痛苦的人類經歷轉變為病態的感受；進入他們聲稱會從醫療中受益的醫療狀況——在這種情況下，治療意味著，是的，你猜對了，是一顆藥丸。
It appears that the authors of the above study have already developed a screening tool to diagnose the disorder and my curiosity gets the better of me as I click on the link to take a look at it. I’ll just see what it says, I say to myself, but I end up printing the document and completing it. Ooh I’m pretty damned angry now, and for the first time in 12 months, I feel an intense desire to write; a desire to write a response and explain to these well-intentioned so-called experts just how I feel about their attempt to turn a highly distressing and excruciatingly painful human experience into something pathological; into a medical condition that they assert would benefit from medical treatment – and treatment in the case means, yes you’ve guessed it, a pill.
讓我從一些篩選工具問題開始。
Let me start with some of the screening tool questions.
Q1：在過去的一個月裡，我有多少次感到自己渴望或懷念 Olly？
Q1: In the past month how often have I felt myself longing for or yearning for Olly?
我：每一天
Me: EVERY SINGLE DAY
Q2：在過去的一個月裡，我有多少次因為失去的關係而感到強烈的情感痛苦、悲傷或悲傷的痛苦？
Q2: In the past month how often have I had intense feelings of emotional pain, sorrow, or pangs of grief related to the lost relationship?
我：每一天
Me: EVERY SINGLE DAY
Q3：對於上面的問題 1 或 2，我是否至少每天都經歷過這些“症狀”，並且在他去世後 6 個月之後？
Q3: For questions 1 or 2 above, have I experienced either of these “symptoms” at least daily and after 6 months have elapsed since his death?
我可以
Me: YES
Q4：在過去的一個月裡，我有多少次試圖避免提醒 Olly 走了？
Q4: In the past month, how often have I tried to avoid reminders that Olly is gone?
我：每一天
Me: EVERY SINGLE DAY
Q5：在過去的一個月裡，我有多少次因為失去而感到震驚、震驚或茫然？
Q5: In the past month how often have I felt stunned, shocked or dazed by my loss?
我：每一天
Me: EVERY SINGLE DAY
Q6：我是否對自己在生活中的角色感到困惑或不知道自己是誰（即感覺自己的那一部分已經死去）？
Q6: Do I feel confused about my role in life or feel like I don’t know who I am (ie. feeling that part of me has died)?
我：有點
Me: QUITE A BIT
Q7：我接受損失有困難嗎？
Q7: Have I had trouble accepting the loss?
我：壓倒性的
Me: OVERWHELMINGLY
Q8：自從我失利後，我是否很難相信別人？
Q8: Has it been hard for me to trust others since my loss?
我：有點
Me: QUITE A BIT
Q9：我會因為失去而感到痛苦嗎？
Q9: Do I feel bitter over my loss?
我：有點
Me: QUITE A BIT
Q10：我覺得現在繼續前進（例如，結交新朋友，追求新興趣）對我來說會很困難嗎？
Q10: Do I feel that moving on (eg, making new friends, pursuing new interests) would be difficult for me now?
我：有點
Me: SOMEWHAT
Q11：自從失去後，我是否感到情緒麻木？
Q11: Do I feel emotionally numb since my loss?
我：有點
Me: QUITE A BIT
Q12：自從失去之後，我是否覺得生活不充實、空虛或沒有意義？
Q12: Do I feel that life is unfulfilling, empty, or meaningless since my loss?
我：有點
Me: QUITE A BIT
Q13：我的社會、職業或其他重要功能領域（例如家庭責任）是否顯著減少？
Q13: Have I experienced a significant reduction in social, occupational or other important areas of functioning (eg domestic responsibilities)?
我可以
Me: YES
結果：長期悲傷障礙
Result: Prolonged Grief Disorder
我對結果的解釋：我身心健康的 24 歲兒子 Olly 於 2021 年 4 月 27日因一場悲慘而離奇的事故突然可怕地去世。我對上述問題的回答反映了我的痛苦在我美麗而心愛的兒子遭受創傷、不合時宜和毫無意義的死亡之後，人類對災難和心碎的反應是痛苦但自然和可以理解的。
My interpretation of the result: My physically and emotionally healthy 24-year-old son, Olly, died suddenly and horrifically as the result of a tragic and freak accident on the 27th of April 2021. My answers to the above questions reflect my excruciatingly painful yet natural and understandable human response to the devastation and heartbreak that have followed in the wake of the traumatic, untimely, and senseless death of my beautiful and beloved son.
在奧利去世幾週後舉行的慶祝活動中，朋友和家人站了起來，分享了他們與奧利分享的一些神奇而獨特的時刻。儘管我很想站起來說話，但我還是選擇了不去。相反，我請指導我們完成儀式的司儀宣讀我寫給奧利的一封信。從那以後，我每天晚上都給他讀那封信，並打算盡可能地這樣做。
During a ceremony to celebrate Olly’s life held a few weeks after his death, friends and family stood up and shared some of the magical and unique moments they’d shared with Olly. Although desperate to stand up and speak myself, I chose not to. Instead, I asked the celebrant guiding us through the ceremony to read out a letter I’d written to Olly. I’ve read that letter to him every single night since then and intend to do so for as long as I’m able.
對我來說，信件似乎是一種強有力的表達方式，可以傳達我內心的想法、感受和行動，考慮到這一點，我寫了以下信給 Holly G，Prigerson，Ph.D 和 Paul K. Maciejewski，Ph. .D，上述篩選工具和試驗研究的作者和共同作者。
It seems that letters are a powerful and expressive mode for me to convey my innermost thoughts, feelings and actions and with that in mind, I’ve written the following letter to Holly G, Prigerson, Ph.D and Paul K. Maciejewski, Ph.D, the authors and co-authors of the above-mentioned screening tool and trial study.
親愛的Holly和保羅
Dear Holly & Paul
嚴重地(認真地)？ Seriously?
癮？ Addiction?
你在開玩笑嗎？ You’re kidding me?
我想知道你是否經歷過孩子、伴侶、配偶或朋友的死亡？
I’m wondering if you’ve you ever experienced the death of a child, a partner, a spouse, or a friend?
你是否與你的人性以及作為人的意義失去了聯繫？
Have you lost touch with your humanity and with what it is to be human?
我很想知道你是否知道深深地感受到愛以至於它真的很痛是什麼意思？
I’d be interested to hear if you know what it is to feel love so deeply that it literally hurts?
我可以毫不含糊地告訴你，我沒有精神錯亂，而且我肯定不會沉迷於悲傷。更重要的是，我更加確定我不需要或不需要藥丸來幫助我擺脫對 Olly 的記憶，也不需要讓我擺脫對我美麗兒子 Olly 的渴望、渴望或全神貫注。就在 12 個月前，年僅 24 歲的他不幸離世。
I can tell you in no uncertain terms, that I’m not disordered, and I most certainly am not addicted to grieving. And what’s more I’m even more certain that I don’t need or want a pill to help rid me of my memories of Olly nor to rid me of my yearning for, my craving for or my preoccupation with my beautiful son Olly, who died tragically and horrifically just 12 months ago at the tender age of 24.
我感謝你的關心，但我真的不需要也不想讓你擺脫我對他的記憶，因為它們有一個非常重要的目的。它們每天都讓我想起他厚顏無恥的笑容和濃密的鬍鬚，他的幽默和他把吃了一半的蘋果核留在沙發墊之間的惱人習慣。它們讓我想起了他臥室裡的臭味，想起了他堅定的自我意識，想起了他有尊嚴地保持自己脆弱的方式。他們讓他的善良和溫柔的天性和他在所有音樂方面的空前天賦都在我腦海中鮮活。我對他的那些記憶讓我充滿了悲傷，但同時也讓我的臉上露出了笑容。他們給我帶來了一種溫暖的滿足感和自豪感。有時他們給我一種目的感。他們每天早上幫我起床，把一隻腳放在另一隻腳前面。它們讓我想起什麼是對另一個人的愛，什麼是我被愛的感覺，它們讓我想起什麼是做人。我什至會說他們讓我活著。
I thank you for your concern, but I really don’t need or want you to rid me of the memories I have of him, because they serve a very important purpose. They remind me each and every day of his cheeky grin and his bristly beard, of his humour and his irritating habit of leaving half-eaten apple cores between the sofa cushions. They remind me of the stinky smell in his bedroom, of his solid sense of self, of the way he held his vulnerability with dignity. They keep his kind and gentle nature and his unprecedented talent for all things musical alive in my mind. Those memories I have of him fill me with sadness yet at the same time they bring a smile to my face. They arouse a warm sense of contentment and pride in me. Sometimes they give me a sense of purpose. They help me to get out of bed each morning, to put one foot in front of the other. They remind me of what it is to feel love for another human being and feel that I am loved, and they remind me of what it is to be human. I’d even go so far as to say that they keep me living.
你可能會給我貼上精神錯亂的標籤，相信我在否認，或者我明顯無法接受他的死是不健康的。但請相信我，它完全健康，而且對我毫無疑問有幫助。不要誤會我的意思，我並不幻想他已經死了，他的心臟不再像你我的那樣跳動，也不再通過他的靜脈抽血，或者他不再能夠呼吸我們周圍的空氣進入他的肺。我痛苦地意識到我不能再像上次看到他活著時那樣摟著他寬闊的肩膀，緊緊地擁抱他，輕輕地吻他的額頭。
You might label me as disordered, believe that I’m in denial, or that my apparent inability to accept his death is unhealthy. But believe me, it’s totally healthy and it’s unequivocally helpful for me. Don’t get me wrong, I’m under no illusion that he’s dead, that his heart no longer beats nor pumps blood through his veins like yours or mine, or that he’s no longer able to breathe in the air that surrounds us into his lungs. I’m painfully aware that I can no longer wrap my arms around his broad shoulders, squeeze him tightly and gently kiss his forehead as I did the very last time I saw him alive.
我怎麼能否認這一點，在他25歲生日那天，我赤手空拳地將他的骨灰撒在了一個天然墓園的地上，將他還給了他現在所屬的宇宙。你看，儘管他不在場，他仍然非常活躍，他的精神和他的能量像風一樣在我周圍和我體內狂風吹拂，無論我走到哪裡，他都會繼續與我同行。當我在林地或河岸邊漫步時，他與我同在；當太陽落山時，當我在晚上閉上眼睛時，他就在我身邊；當日出和我醒來面對新的一天時，他和我在一起。
How could I deny this, when, with my bare hands, I sprinkled his ashes onto the earth in the grounds of a natural burial park on the day of his 25th birthday and gave him back to the universe where he now belongs. You see, despite the absence of his presence, he is still very much alive, his spirit and his energy gusts around me and within me like the wind and he continues to walk alongside me wherever I go. He is with me as I wander through the woodlands or along the riverbanks; he is with me when the sun sets and when I close my eyes at night; and he is with me when the sunrises and when I wake to face yet another day.
他是，而且永遠是我的一部分。畢竟，他的生命開始於我之內，當他依偎在我的腹部時，他聽到了我的心跳，我感覺到他的小四肢在我的子宮壁上推踹。我給了他生命，我養育了他，餵養了他，無論是嬰兒、蹣跚學步的孩子、孩子、青少年還是年輕人。我親眼目睹了他越來越自信，並形成了自己對生命和宇宙的看法。儘管很艱難，但當他開始展開翅膀並在這個世界上走自己的路時，我靜靜地退後。
He is, and always will be a part of me. Afterall, his life began within me, he heard my heart beating as he lay nestled in my belly, and I felt his tiny limbs pushing and kicking against the wall of my womb. I gave him life, I nurtured him and fed him, as an infant, as a toddler, as a child, as a teenager and as a young adult. I witnessed him as he grew in confidence and developed his own view on life and the universe. And as hard as it was, I stood back quietly as he began to spread his wings and make his own way in this world.
你可能有興趣了解我的信念，即我永遠不會“克服”奧利的死，我也不想這樣做，因為那樣做意味著羞辱他的生命、他的名字、他的精神、他的精力和非凡的遺產他離開了，儘管他不在場，但它仍然繼續存在。“克服”他的死對這個獨特而光榮的年輕人來說簡直是不公平的。
You may be interested to know about my belief that I will never “get over” Olly’s death, nor do I want to, because to do that would mean to dishonour his life, his name, his spirit, his energy and the extraordinary legacy that he leaves behind and which continues to live on despite the absence of his physical presence. To “get over” his death would quite simply be an injustice to this unique and honourable young man.
最後，盡一切努力研究悲傷背後的“科學”，儘管我傾向於認為這會浪費你的時間和金錢。我建議您最好將時間和金錢花在學習如何簡單地與另一個孩子、父母、兄弟姐妹、伴侶或朋友已經去世的人坐在一起。您可能希望進一步開發您的內在資源，以便您有勇氣和力量見證他們經常無法忍受的痛苦，並且當您這樣做時，查看Dan Siegel博士關於一個人的“窗口期”的概念可能會有所幫助寬容”。通過讓一個人感受並克服他們的痛苦，而不是試圖用藥丸讓他們麻木，我建議你對它的機制和安全性知之甚少，
And finally, by all means put your efforts into researching the “science” behind grief, although I tend to think that it will be rather a waste of your time and money. I’d suggest that your time and money would be better spent in learning how to simply sit with another human being whose child, parent, sibling, partner, or friend has died. You may wish to further develop your inner resources so that you have the courage and strength to witness their often-unbearable pain, and while you’re at it, it might be helpful to look up Dr Dan Siegel’s concept of a person’s “window of tolerance”. By allowing a person to feel and work through their pain, rather than trying to numb them into oblivion with a pill, the mechanisms and safety of which, I’d suggest you know very little, you might find that you actually help someone learn how to live with the fact that their loved one has died instead of labelling them as disordered and telling them that they need to “get over” it.
感謝您花時間閱讀我的信。
Thank you for taking the time to read my letter.
帶著最誠摯的祝福
With kindest wishes
Sue Irwin
來源:
https://www.madintheuk.com/2022/05/grief-is-never-a-disorder/
蘇·歐文Sue 是一名個體經營的園丁(self-employed gardener)、熱情的語言學家和 3 個孩子的媽媽。她在童年時期經歷了反复的虐待性虐待，並在英國的心理健康系統中擔任了 18 年的服務用戶。蘇現在利用這些經驗來支持就讀伍斯特大學的心理健康和社會關懷學生的培訓。她曾在法定機構和第三部門組織中擔任同伴支持角色，目前參與當地由同伴領導的支持小組，為戒除精神科藥物的人提供支持。Sue 還在考文垂大學攻讀社會與治療園藝學碩士學位。
