COVID-19 pandemic is a human crisis with significant bio-psycho-social-spiritual consequences. The sudden loss of loved ones, and restrictions in end-of-life care and funeral rites have further complicated the grief and bereavement process. The pandemic also contributed to a phenomenon of survivor guilt. 

 

This presentation aims to examine the multifaceted, complex losses and grief experienced by a COVID-19 survivor. It highlights the importance of rituals in grief which can serve as therapeutic tools in transforming guilt.  The provision of grief and bereavement support are also reviewed. 

 

A case study was used to illustrate the multidimensional grief reaction experienced by M, a COVID-19 survivor who lost her mother during the pandemic. The 4 Ps of case formulation – predisposing, precipitating, perpetuating, and protective factors were used as a framework to identify the factors leading to M’s presentation. William Worden’s Task Theory and Continuing Bond Theory were used in processing M’s grief. 

 

Our grief assessment established that M suffered from inhibited grief and survivor guilt with no closure from the sudden, unexpected loss of her mother. Her insecure-avoidance attachment style and dissonant grieving style further complicated her situation. This impacted her relationship with her siblings and affected her faith. The initial counselling approach focused on the acknowledgement of M’s loss by creating a safe space for catharsis. A family meeting was held which served as a platform for forgiveness, reconciliation and affirmation. Therapeutic ritual was developed to transform her guilt into legacy action which continued her bond with the deceased. Her religious leader also played an important role in reconstituting her faith.

 

Psychosocial and mental health support are equally important as medical support in caring for patients during the pandemic. While survivor guilt is distressing, it is associated with post-traumatic growth and can be transformed into a positive lesson which is potentially lifesaving.