Relieving Traumas - Soothing Hearts: The Role of Grief Counseling in Sri Lanka
Photo courtesy of Sanju Rangodage
Virasha Godakanda
BA Hons. in Sociology - University of Ruhuna, Sri Lanka
Memories of loss and resilience are deeply ingrained in the collective experiences and cultural history of the Sri Lankan people. As a nation committed to exploring reconciliation through unity, we often overlook one powerful element: grief counseling. Sri Lanka has seen numerous incidents of mass trauma, for which there has been repeated exposure to the serious aftermath of such incidents. Among these painful national disasters, one constant issue that arises is that there are no formal intervention structures available which can provide grief counseling and psychosocial support (Somasundaram, 2010; Husain et al., 2011). The public health care system in Sri Lanka has the potential to provide such services, but currently lacks the necessary resources and trained professionals. There is a significant shortage of grief counseling therapists in the country, with only a limited number available to meet the needs of the population (Abeysinghe & Ekanayake, 2021). For example, while assessment tools for depression and PTSD are available and in use, the infrastructure for comprehensive grief counseling and psychosocial support remains underdeveloped (Ibid., 02). This highlights the urgent need for the development of formal intervention structures and the training of more mental health professionals to provide these essential services. The deep losses suffered by impacted communities during times of civil war, the 2004 tsunami, the 2019 Easter Sunday Bombing incident, the Covid-19 global pandemic, and ongoing economic and political crises in Sri Lanka have not been met with adequate mental health and social support services. There is a critical need for accessible, culturally sensitive grief counseling and trauma-informed care to help individuals and communities heal and build resilience. It leads individuals to depend on informal support networks rather than seeking professional support. While professional counseling can play a crucial role in healing, it's important to recognize that, in contexts like Sri Lanka, informal support networks such as family, friends, and community groups often provide vital emotional and psychological support. As Watters notes, community-based approaches can sometimes be more culturally resonant and effective than Western-style psychological interventions. While informal, community-based approaches to grief are deeply valuable in Sri Lanka, there remains a need for culturally sensitive grief counseling services to address the long-term psychological effects that these events can have.
Counseling is a dynamic and valuable professional relationship between a trained counselor and their client. The primary role of counseling is supporting clients to gain deeper understanding and clarity about their life situation. Doing so, in turn, helps them to make informed choices and create a path toward achieving the client's self-determined goals by overcoming their emotional or interpersonal challenges (Mat Nor, 2020). Grief is an intense emotional response to loss that goes beyond mere sadness. Unlike sadness, which is typically a transient feeling, grief can profoundly reshape our entire perspective and significantly impact daily life. It often manifests in physical sensations, heightened anxieties, and a range of complex emotions. According to research, grief is a normal response to hardship and loss, and it is important to recognize that while it can be deeply disruptive, it does not necessarily indicate a pathological condition (Wittkowski & Scheuchenpflug, 2021; Peña-Vargas et al., 2021).
When experiencing grief, psychological intervention can be a valuable resource as counseling provides the support individuals need to navigate this complex emotional journey. Kato and Mann (1999), in their study of grief, argued that psychological care is a natural and effective choice for grief interventions. Through grief counseling, individuals who have suffered a loss are empowered to openly express their deepest thoughts and emotions, gaining the coping skills to manage the difficult grieving process (Adikwu, 2022). While some people may cope with loss on their own, others may seek the guidance of a grief counselor when their grief becomes hard to handle (Worden, 2010).
There are three pivotal objectives that guide the healing process in grief counseling. The first and most essential is to acknowledge and fully immerse oneself in the intense emotions that come with grief. The second objective involves recognizing any detrimental behavioral patterns that have emerged after the loss, especially in cases of complicated grief where emotions have been pushed aside and unhealthy coping mechanisms have taken over. The goal of grief counseling is to provide an opportunity to engage with unresolved aspects of grief and thus create a way for moving forward (Kheeran, 2010). However, it is important to acknowledge that the grief process is not linear, and it is varied cross culturally as well. According to Kheeran, the process involves navigating through various stages and emotions that may recur over time. This non-linear reality of grief highlights the need for flexible and adaptive counseling approaches that can accommodate the unique and evolving experiences of each individual.
Grief is also not universal: what provokes grief, its meanings, and expressions, will vary across cultures. In a comprehensive reference article entitled "Grief Counseling Resource Guide," Carpinello examines the diverse ways that people express grief—whether physically, behaviorally, cognitively, emotionally, or spiritually. It contains a wide array of critical topics concerning the understanding of grief including types of grief, stages of grief, reactions and symptoms, coping methods in grief counseling, the use of support groups and community resources, cultural and religious beliefs about death and dying, complex grief and trauma, children's and adolescents' grief, work-based grief, and finally, legal and practical considerations. Any increase in offerings of grief counselling in Sri Lanka will need to be informed by and adapted to local particularities, which may vary across the country or even within populations.
There are examples of public health counseling programs globally that Sri Lanka can learn from. For instance, in Australia, the Centre for Grief and Bereavement provides comprehensive support, such as counselling, education, and advocacy, for those experiencing grief (Beyond Blue, 2023). In Israel, where conflict and loss are prevalent, individuals have access to various grief counselling resources and support groups through organizations like Alma (https://www.getalma.com/), a non-profit organization, focused on providing trauma-informed grief counselling and support services to families impacted by violence and loss (Yalom, 2022). Similarly, in Rwanda, after the tragic genocide, dedicated efforts have been made to provide compassionate grief counselling and community support through Kigali Genocide Memorial Centre, which provides extensive services, including grief counselling, to survivors and their loved ones (Newsom et al., 2017; Kigali Genocide Memorial Centre, n.d). These models can help Sri Lanka develop its own version of accessible, culturally sensitive mental health services, integrating both formal counseling and community-based support systems to address the country's unique needs.
At present, Sri Lanka’s main hospitals have psychologists and counselors, trained to offer grief counseling (Ministry of Health, 2023). The individuals referred to as Case Managers are dedicated civil servants who play an essential role within the Office of Reparation by helping victims of various traumatic incidents. These services are predominantly attentive to domestic violence cases and children affected by sexual abuse (Ibid.). It is now evident that these services need to be widely available in the health system to accommodate a more comprehensive understanding of grief and its emergence in connection to a wide range of traumatic events. In addition to services provided in the hospitals, other organizations such as National Institute of Mental Health, the Psychological Association of Sri Lanka, and Sumithrayo (https://srilankasumithrayo.lk/) offer comprehensive services in grief counseling (Sri Lanka Psychological Association, 2023; Sumithrayo, 2023). These initiatives are part of the 2017 National Mental Health policy. However, this policy primarily focuses on general mental health services and does not adequately address the specific needs related to trauma resulting from events like the Easter bombings. As noted by Fernando et al. (2012), early psychosocial interventions are crucial to reducing the long-term effects of trauma, highlighting the need for a more targeted approach in the existing framework. As noted by Fernando et al., early psychosocial interventions are very important to reduce the long-term effects of trauma (Fernando et al. 2012).
Call to Action
People can make a considerable change via advocating for increased funds and resources to mental health organizations, supporting organizations that can provide grief counseling, by continuing to raise awareness of the conversations around loss and psychological wellness, and by participating in community-based healing initiatives. By these attempts, we are not only serving those affected already and, in the future, but also reinforcing the ties that will bind us as a nation together. Through these efforts, we can help individuals and communities find healing and resilience, fostering greater emotional well-being and connection. In doing so, we address both immediate needs and future challenges, ensuring that mental health support becomes a cornerstone of a more compassionate and supportive society. By prioritizing these efforts within Sri Lanka, we can build a robust framework for mental health support that addresses the unique cultural and social dynamics of the country, ultimately creating a foundation for a more compassionate and resilient society.
References
Abeysinghe, N., & Ekanayake, E. S. (2021). Where Ethics and Culture Collide: Ethical Dilemmas in Grief Work Following the Easter Sunday Attacks in Sri Lanka. SpringerLink.
Chandradasa, M., Rathnayake, L. C., Rowel, M., & Fernando, L. (2020). Early phase child and adolescent psychiatry response after mass trauma: Lessons learned from the Easter Sunday attack in Sri Lanka. International Journal of Social Psychiatry, 66(4), 331-334. https://doi.org/10.1177/0020764020913314.
Ekanayake, S., Prince, M., Sumathipala, A., Siribaddana, S., & Morgan, C. (2013). "We lost all we had in a second": Coping with grief and loss after a natural disaster. World Psychiatry, 12(1), 69–75. https://doi.org/10.1002/wps.20018
Peña-Vargas, C., Armaiz-Peña, G., & Castro-Figueroa, E. (2021). A biopsychosocial approach to grief, depression, and the role of emotional regulation. Behavioral Sciences, 11(8), 110
Thomas, F. C., Divirgilio, R., Jayawickreme, N., Sivayokan, S., McShane, K., & Jayawickreme, E. (2023). Coping with the long-term impact of civil strife: A grief-centered analysis of Tamil Sri Lankan communities affected by ethnopolitical conflict. Asian-Pacific Journal of Health Psychology. Advance online publication. https://doi.org/10.1111/aphw.12491
Wittkowski, J., & Scheuchenpflug, R. (2021). Evidence on the conceptual distinctness of normal grief from depression: A multi-faceted analysis of differential validity. European Journal of Health Psychology, 28(3), 101–110
