Author(s): Ornella Raymundo Villalva
Due to the impact of the pandemic, a development of existential crises is observed in the human being that makes him rethink his way of being and being in the world, all these changes, worldwide, have opened a contact with death and finitude of existence. Faced with this, fear of death, doubts about the meaning of life, the perception of restricted freedom are identified and places the human being in contact with his loneliness [1]. It mobilizes the foundations of everything that was taken for granted, everything that was held under control. However, it is known that sooner or later, the human being will find a way to adapt, to have creative adjustments to the new. Gecele and Francesetti stated that in these times (year 2020) many of the certainties, daily habits, routines and ways of living that were guaranteed are dissolving [2]. Both authors invite us to reflect on the “support”, opening questions such as what kind of support is necessary so as not to be dominated by fear? and comment on the dimension of individual insufficiency and the need of the other, as if in moments of in crisis, the person will need another with whom to bond and support himself, like a child who experiences strong pain and fear, looking for loving arms that can give him containment.
If we start from the conception that we are beings in the world with one another, we can consider that everything that affects the world affects us individually, there is no way to avoid feeling the impact, there is no way to flee. According to Alvim, we are subject to the contingencies of the world, with events that affect us, surprise us and unbalance us, thus summoning the human being to create to return the balance and continue transforming and transforming the world [3]. In this new configuration, man becomes aware of his unifying relationship with the world, which Ribeiro speaks of “Environmentality” and Perls, et al. of “Organism / environment relationship”, implies that we cannot talk about one without the other being involved [4, 5].
In the current pandemic panorama, mourning, and its rituals were limited under the conditions of health and funeral emergency, what is more, these deaths are considered traumatic and painful, impacting the grieving processes of those who lose a loved one, and exacerbating the fear of death in society. Authors such as Klüber- Ross and Kovác report that fear is the most common psychological response to death [6, 7]. The fear of dying is universal and affects all human beings, regardless of age, sex, socio-economic status, creed and religion. The pandemic has reformulated many aspects of the experience of dying and its rituals, both in the West and in the East [8]. This has an important impact on psychological maturation in the face of death, since these rituals help people become aware of the loss and start their grieving process. A study conducted by Oliveira-Cardoso, et. to, sought to identify the effects of the suppression of funeral rituals during Covid 19 on bereaved families [9]. The most important findings are the perception of an unexpected, frightening and invisible death, the authors report that the unpredictability of the scenario and the fear of the unknown created a climate of generalized fear, where two possible threats are identified: the loss of the relative and the loss of the sense of control over events, triggering experiences of helplessness. They also refer that the wide dissemination of information by the mass media, and the invisibility of the virus contributed to fueling skepticism in the population. Then, society is faced with an invisible and highly dangerous virus that enhances persecution anxiety, where the feeling of threat is constant, the loss of control of protection of the family is broken, since this virus can invade any space and refuge existing, then one lives in a loss of safe space, bringing a sense of unreality in front of the disturbing experience of life. The second experience of the grieving relatives is a loss without time to say goodbye, a cycle that does not close. It has to do with a sudden way of presenting the disease, an irreversible picture that sets in and does not give opportunity, neither to the person who is going to die, nor to the relatives of the preparation for the possibility of death. The authors mention this aspect as especially cruel and tragic, since, being a rapidly evolving disease, where the person suffers and dies alone, in a situation of intense suffering leads family members to reexamine certain misconceptions and beliefs. In addition, since this is a traumatizing experience of loss, the high risk of contagion prevents the bodies from being veiled, in some cases the lifeless bodies stayed at home, due to the lack of funeral services, this fact being a high emotional impact for family members who have to sleep next to their deceased loved one. The terrible humanitarian catastrophe, due to the health and funeral emergency, was a factor of “dehumanization” that altered the funeral rituals, with a short wake time, a reduced number of people present and a closed coffin; The mourners had to face the stigmas associated with the disease, since the grieving person is no longer perceived as vulnerable, in need of support and protection, and becomes stigmatized as a potential vector of transmission, as a threatening object, which generates more loneliness and discouragement.
The absence of rituals of farewell to the body hinders the psychic concretization of the loss, associated with sudden and unexpected death, they prevent preparation for mourning and thus deal withthe loss, Oliveira-Cardoso, et. al, report that once the temporality of physical death does not accompany social and psychic death, difficulties can be generated in the elaboration of grief, these findings report disturbances in the time lived [9].
In order to delve into the concept of Temporality or the consciousness of time, two important characteristics are described: The first is that they are experiences that run in constant succession, whose flow does not stop and cannot be stopped; And, the second is that it is carried out by itself and by virtue of its peculiar intentional structure. For Husserl, what is remembered sinks more and more into the past, but not only that, but what is remembered is by necessity something that has sunk, something that necessarily admits an obvious recollection that takes him back to a now that re-occurs [10]. From a Gestalt vision, a phenomenon becomes a figure, supported by the previous apprehensions of the subject (past), loaded with an intention and significance, which opens up a protection (future) as expectations. All this, in constant flow of a Now, an integrated present of a temporary being.
Costa, et, al. They refer that the Kronos time, which means the notion of a stopwatch, can be differentiated from the Kairós time, related to the internal time of maturation (lived time) [11]. In the phenomenological-existential perspective, temporalizing implies experiencing time. The authors comment that time is experienced as a totality, which encompasses what has already happened, as well as what will happen. Validating that the experience of time is unique for each person, it is thus that all past and future with a significance will be past and future represented in the present, since existence is a reality oriented and referenced to a future as a have- to- being, where the past and its retention is part of its constitution, and therefore one cannot exist without the other, that is the flow of its necessary connectivity. For Polster and Polster, the past and the future form the limits of present experience, facilitating the recognition of what has already been and what can become [12]. Then, the Being is no longer seen as a set of events dissociated from each other, and the Being is shown in its entirety as a Being in a lived space and time. Therefore, it is understood that the focus in Gestalt therapy is directed to observe, describe and understand how the experience is being lived, remembered and represented in the present. As Costa emphasizes, clinical practice is interested in how these retentions and protensions (past, future) are manifested in the patient’s experience in the here and now, since the significant past is the one that appears represented in the Now, then, the past that has significance is brought to the present [13].
What happens if faced with an event of great impact, such as the pandemic, it limits, crystallizes, or stiffens the experience of temporality? Polster and Polster call a disturbance of awareness of time, the lack of reference to the past, or the future and experiences stagnant in one of those temporary moments, which ends up obfuscating the existential possibilities of the person [12]. For Costa, et al. to the suffering is in the non-consciousness of a fluid time, and in a state of fixation in one of the times, losing the notion of its dynamism. Existential suffering consists in the stagnation of the existential maturation of the being-in-the-world, the immobilization of the time lived by Kairos, losing the notion of temporal continuity. This is how the person remains crystallized, fixed, stiffened in a only way of acting (living in the past, or in the future). Therefore, they are less able to meet any of their survival needs Costa, et. to the [11].
It should be considered that a healthy functioning is one that iscapable of growing, assimilating and acting spontaneously, without alignments, but in full contact with the present, with what happens in its environment in the Here and Now, since its behavior It will be healthy or not, depending on the satisfaction of your need to the one who is oriented in full contact with the environment (self- regulation). Then, a temporary fixation (past, future) that interrupts the contact between organism / environment, will limit the fluid vision of the individual as a whole, and therefore would cause a dysfunctionality of their actions in the face of the circumstance that they are living. That is, Perls, et al, refer that, if the individual becomes alienated due to false identifications, and tries to limit his own spontaneity, his life becomes insipid, confusing and painful [5]. His behavior would be repetitive, lacking present contact and fixed in inconclusive Gestalten. While Latner, describes that what is healthy is the ability to deal satisfactorily with any situation with which the human being faces, in a constant creation and destruction of Gestalten, the individual would be authentic and spontaneous based on his full contact with himself and with the environment [14].
Spagnoulo and Schulthess report that there was a new interest in a new spontaneity in the contact process between the therapist and the client [15]. Where you choose to address what is normal (functional) in your studies and restrict your observation to what can be experienced in the therapeutic situation. Therefore, it is based on the perception of the organism / environment field in the here and now, what it seeks is to consider the role of psychotherapy as an external support for the intentionality of the contact, which the client would have otherwise repressed in a process of creative adjustment with its surroundings. The Gestalt therapist lends himself entirely to the genuine encounter or full contact, with a person who needs a stable and welcoming support to deepen his painful wounds, reestablish his contact and thus enable the client to find new ways of adjusting to the moment that you have to live. It is a tissue of presence where the loving therapeutic field is restorative and necessary for healing, Spagnoulo refers that this existential pandemic crisis is a good opportunity for both the client and the therapist to emerge as a “we” rather than a “me.” Spagnoulo M [16].
Humanity is facing a collective trauma, it is creating a way to face the fear of death, like the incredible thing to believe, until it is time to live it. Carries suspended and poorly elaborated duels, this fear is exacerbated, opening the way to the intensification of psychopathological conditions and disturbances in the temporality. For this reason, the importance of a clinical intervention that, of support and containment in the face of human pain, is highlighted, working in a therapeutic bond with a reflective look on being here and now, which allows integrating and restoring the fluidity of temporality, such as necessary way to adapt to new life circumstances. Spagnoulo and Schulthess in their recent article where they talk about the fear of death and the need for roots, report that it is the turn of relational Gestalt therapy to show itself, since it prioritizes the genuine encounter as restorative and therapeutic, they comment that there is a great need to be grounded in meaningful and good relationships, where people can breathe and feel themselves [15]. Just as they report that today, it is really difficult to feel in one’s relationship, to feel the sense of a self in a unified relationship. Therefore, there is an absence of relational containment in this context of a pandemic, the intervention of the Gestalt therapist is to offer his presence to meet another, and generate a therapist-client field that allows them to feel that we are there.
Accoroni AG, et al. (2020) The effect of suppressing funeral rituals during the COVID-19 pandemic on bereaved families. Rev Latino-Am Nursing 28: e3361.
