x Abu Dhabi, UAEMonday 24 July 2017

Dubai centre dedicated to dealing with grief

The country's first centre dedicated to helping the bereaved opened in Dubai this year, and is proving to be a lifeline for hundreds of people who have lost loved ones.

Kareen Bekhazi, left, a clinical psychologist, and Carey Kirk, a counselling psychologist, in the children's room at the newly opened Raymee Grief Centre. Razan Alzayani / The National
Kareen Bekhazi, left, a clinical psychologist, and Carey Kirk, a counselling psychologist, in the children's room at the newly opened Raymee Grief Centre. Razan Alzayani / The National

Neatly lined up on a shelving unit just a few feet high sit row upon row of children's toys.

There are plastic dinosaurs, figurines, tanks, teapots, gravestones, cakes, guns, dolphins, teeth and handcuffs, to name just a few.

Hanging on the wall nearby are some small dressing up outfits, giving the children a chance to play doctor, princess, knight or policeman, depending on their mood.

There is also a little blackboard and a bookshelf stocked full of brightly-illustrated stories. It looks like any child's dream playroom. But a closer inspection of the books gives a clue to its true purpose.

Titles such as When Dinosaurs Die - A Guide To Understanding Death, and Lifetimes- The Beautiful Way to Explain Death to Children, would not be found on most youngsters' shelves.

"It all allows children to express what is going on inside their heads," explains Dr Tara Wyne , a UK-trained clinical psychologist at the new Raymee Grief Centre in Dubai. "We cannot always understand what's going on through verbal methods as some children are only 3 or 4 years old. Here they can speak, but through play."

The Raymee Grief Centre in Dubai is the country's first facility dedicated to helping adults and children cope with the loss of a loved one. It is based at the LightHouse Arabia Community Psychology Clinic in Jumeirah and manned by the clinic's staff.

All of its services are offered at no cost. It holds support groups, educational talks, family and nanny consultations, and outreach programmes in the community. The staff who work in the centre are also called to offer help in schools, usually when its pupils are grieving for a fellow student.

They also give grief sensitivity workshops to Human Resource departments to help staff become more "psychologically minded" about grief, better equipping them to deal with employees who may be experiencing it.

Children, especially very young ones, are often ignored when a family member dies, not out of thoughtlessness, but because of their lack of verbal communication skills.

But if a child isn't given the opportunity to properly express how they are feeling, and in turn hopefully understand things better, the behaviours associated with those feelings could remain with them into adulthood.

"There's a lot of ways that grief can impact a child that we are not necessarily aware of," says Carey Kirk, a counselling psychologist trained in the US, and the grief centre programme coordinator. "Sometimes when a child goes through the death of someone close to them, they put on a brave soldier front so that people don't have to worry about them. A lot of children are very aware about how their parents are feeling. They are very intuitive. That can put a lot of pressure on children, and they can carry that throughout their life."

Kirk says the idea to set up the centre came from people already using the LightHouse Arabia's services. "The idea was brought to us by the community," she says. "We loved the idea and it's important for everybody, adults and children, to have access to support services for grief."

One person to benefit already is Gordon, who was just 3 when he lost his father to cancer last year. "The thing I found challenging was what to communicate to him and what to tell him," says his mother, who requested not to be named to protect her son, "and how to tackle some difficult questions about death, especially to someone who doesn't have the cognitive understanding of these things."

In order to help Gordon, his 35-year-old mother took him for play therapy, while she had one-on-one sessions.

The clinical psychologist playing with Gordon, now 4, was able to tell his mother how he was feeling by watching the toys he chose to play with, and exactly how he chose to play. His mother learned that he was knocking over all the toys in the room during the sessions, a clear sign of frustration.

"He also had a fascination with burying things in the sand," she recalls. "The benefits of the play was getting feedback on how he was doing. As a parent going through a loss you worry so much 'is he doing ok?' and 'is he getting better?'.

"I learned how as a parent I could change my behaviour and provide ways at home for him to let his feelings out. Initially I was telling him really vague thing like 'he is in the clouds'. She let me know I had to be more firm with facts and to make him understand that his father wasn't coming back, because not doing that can lead to a lot of anxiety because they think they have been abandoned."

Gordon's mother, who works in banking and has lived in Dubai for six years, also had private counselling and took part in a handful of group support sessions.

"Within that hour you just spend time thinking about things that you wouldn't have otherwise, things that if you think about, can help you really move on," she says. "I would recommend it to anyone who has lost someone."

The support groups, held every two weeks, are split into four age groups from the 3 to 5 years group, up to the adult group.

The centre is built on the same principles as The Dougy Centre, which was established in 1982 as the first centre in the US to provide peer support groups to grieving children.

Kirk says the idea to bring the programmes to the UAE came from people the LightHouse Arabia was already helping.

"People have always have the opportunity to go see a psychiatrist or psychologist but a lot of times people are grieving don't need actual counselling, they need support services and to know they are not alone.

"Grief is very isolating and it changes you as a person. And often when someone goes through that experience, the people around them say that that person has changed and they have a more difficult time relating to that person."

Everyone joining a grief support group has a private intake meeting for the staff to ascertain whether the grief support group is right for them.

In the adult support group there is around eight people, plus a psychologist, who refer to themselves as "participants" or "facilitators".

In a country as transient as the UAE it is maybe no surprise that the 90-minute sessions attract the maximum number of participants - around eight - virtually every time.

"The lack of consistency with the environment and support system is difficult," says Kareen Bekhazi , a clinical psychologist at the centre. "Maybe no one knows who that loved one was, so how can you express how you feel about that person?

"Before you get support, you have to tell them 'this is the person, and this is what they meant to me', it's a lot of work to do before getting support. This is where we can help."

The staff are keen to stress that the support groups are not group counselling sessions, they are comfortable forums for people to express themselves around other people who may be in a better position to offer support than people who have not experienced grief themselves, they say.

"Grief is something that everybody experiences in a different way and I think a lot of people get a lot of comfort seeing how other people are feeling and managing with it," says Bekhazi.

For Gaby R, who has lived in Dubai for more than 20 years, the Raymee Grief Centre has provided an environment to express herself that she would have been unlikely to find in any of her friends.

The 46-year-old marketing and events director says her life was perfect until 2009, when her father died of cancer. Then just a year later she miscarried a pregnancy she had waited years to have.

"It was devastating," she says. "I was over the moon to be pregnant, I had always wanted a baby and I was 44 when I got married so I was very lucky. At the time I felt like I was the only one my friends to experience it because people don't talk about that sort of loss."

While still grieving for her child, Gaby found out on January 23 this year that her younger sister had committed suicide.

"The last three years have been so hard. I have had to redefine myself. I was a sister, and a daughter and a mother. This has all changed."

Gaby found out about the centre in March and was the only person at the first support group.

Since then the numbers have grown, and with every person comes a new perspective, she says.

"If you tell the same people the same story again and again it loses its edge and hardness. It's not that you don't cry, but the story becomes shorter and shorter.

"I have noticed a shift in myself over time. Things are improving. The groups wouldn't be right for everyone, but for me, the more I talk about it, the softer it gets."

Grief can often have difficult physical and mental side effects and there is a big risk, especially somewhere like the UAE, where mental health services are in their infancy, that people might seek medication before any other type of help.

The Raymee staff are keen to educate people about the importance of seeking support for grief before asking for a prescription for medication.

"Grief is about a massive change of identity and you have to realise that you are a different person and you have to live with these changes and catch up," Dr Tara says. "It is an event that has changed the whole building blocks of your life. Medication won't make any change to that but what will make a difference is having other people acknowledge how much of a challenge that is to the foundation of your stability."


The facts on grief

Grief is a universal and natural reaction to loss for both children and adults.

The duration, intensity, and type of emotions experienced in grief are unique to each individual.

Children who are parentally bereaved will generally not display symptoms of grief until approximately six months to a year after the death of their parent.

Even if they are grieving the death of the same person, each individual will experience grief in a different way.

There is no "getting over" grief. Grief is not linear with a start, middle and end. Grief lasts throughout our lifetime and subsides and rises again when we encounter something that reminds us of the deceased.

Unprocessed grief can lead to depression, anxiety, social withdrawal, difficulty forming and maintaining relationships (romantic and social), low self-esteem, and feelings of powerlessness that can last long into adulthood and, in some cases, for the rest of our lives, if not addressed.

Children often do not express the extent of their grief at home out of a concern about upsetting other family members.

Children are more likely than adults to try to mask their symptoms of grief because they do not want to be singled out by their peers as "different".

Common emotions experienced by people who are grieving are: sadness, anger, shock, guilt, loneliness, anxiety, helplessness, fatigue, numbness and relief.

Physical manifestations of grief can include: hollow feeling in the stomach, tightness in chest and/or throat, oversensitivity to noise, breathlessness, lack of energy, nausea, headaches, stomach aches, digestive problems.

Cognitive manifestations of grief can include: inability to concentrate, difficulty remembering, preoccupation with thoughts of the deceased, sensing their presence, and hallucinations (for example, thinking you hear their voice, thinking you see them in a crowd, hearing their footsteps on the stairs, etc).


Source: Raymee Grief Centre