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Loss and COVID-19: The Personal and the Political

Andrew Cooper and Brian Rock introduce the sociopolitical context of the course
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So Brian, tell us something about what the inspiration was for you to commission this course in the first place. Well, for me it’s actually, you know, really extends quite far back in terms of my own personal and professional development. When I was still at university studying my undergraduate degree with no sense that I would become a psychologist or work in mental health, I had the opportunity to train, and then work, in a local hospice in Johannesburg.
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And it was a very powerful and immensely formative experience of really learning about and working with individuals and families who were facing very difficult, challenging, distressing situations and experiences with a member of their family having a terminal illness and having to negotiate all that that entailed for them, as well as having to face a certain death, as it were, in the family, and how to manage the living through that.
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And I think there has been something about living and working through the pandemic that has, I think, again, reconnected me with those experiences and with the way in which it shaped my own thinking about what matters and what’s important, both in ordinary life, but also in working with people who are suffering with emotional distress and mental health issues. I mean, my own story is, of course, different to yours.
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But I think my interest in trying to offer something to the world, as it were, about the experience of the pandemic is also connected to my own relationship to death and dying, and fear of dying through my life because I was very ill twice with a life threatening illness quite young, in my 20s. I survived obviously, and flourished since. It’s given me a kind of a sensitivity to these questions and an interest in them.
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I think one of the interesting important things about the pandemic is that I suspect it’s brought everybody closer to an awareness of mortality, of their own vulnerability as you mentioned. And this has been very important, partly in connecting us together in the way you spoke about, but also in perhaps deepening our relationship to ourselves and one another. Yeah, so in a way, we hope that the course will connect people in its own rights, and bring people together from different nations and cultures with very different experiences. It’s all contributing to that, I hope. These are very, very [INAUDIBLE] emerging.
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Rather set of disturbing information about the fact that actually not everyone is– we’re not all in it together. And there are some people who are far more greatly affected. That includes people from black, Asian, minority ethnic communities. Socioeconomic status, poverty, all play a role in ensuring that actually some of us are actually far better off through this than others. And just any reflections you have on the more political dimensions of the pandemic and how it might intersect with the focus and themes of the course. So we do look at some of these sort of differential impacts of the virus upon different communities.
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I think it’s just terribly important that we are aware that not everybody actually is impacted in the same way, at an individual or a community level. It’s not just that the risks are greater for some people. I mean, they’re somewhat greater for me, someone with an underlying health condition and being older. But equally, there are many ways in which I’m relatively protected and privileged in all of this. I think it’s very important to recognise that if you’re poor, if you’re from a black and minority, in particular certain black and ethnic minority communities, and if you’re a man, then the risks are greater, and have been greater and been shown to me.
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So we’ve seen the kind of very troubling situation in the UK that a large majority of the health professionals who have died of COVID have been from black and minority ethnic backgrounds. And we’re still trying to understand what this is about and what contributes to this. I suppose there’s been an emerging [INAUDIBLE],, particularly around health care provision and working in health care, about the concept of moral injury. And that sort of sense that the invidious position that many health care workers are placed in, where they feel a strong commitment and responsibility to provide care under very difficult circumstances.
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Well, we do look very directly at this question, this phenomenon of moral injury because I became very, very aware of it in the work I was doing with front line workers and with others, in fact. Of people gradually being able to surface in the discussion spaces I was facilitating, the fact that they frequently felt that they were being required to follow guidance, let’s say about discharging frail vulnerable elderly people from hospital to make space, bed space, in the hospitals when they didn’t know that these people often haven’t been tested. And they were going to be discharged back into situations where they might be infecting others, or might be infected by others who also hadn’t been tested.
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And they felt very, very compromised at times. And Charlotte, the social worker who people would encounter, we’ll meet during the course, speaks about this, saying at times she wondered whether she was involved in taking decisions or going along with decisions that would lead to someone dying. And this sits very, very uneasily and painfully for people whose primary motivation for being in work like this is to protect others, to cure them, to alleviate suffering. And yet there they are, knowingly, but without very much sense of choice, obliged to go along with practises that they think might be doing people harm. That’s the really, really difficult conflict.
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And the added dimension of it, of course, is that many of these staff were exposing themselves to risk as well. To me, that sort of heroism is not in the emergency atmosphere of a ICU, but in much more ordinary people navigating those kinds of tensions very courageously, I think. Well, I think that really puts it very well. And I think it’s going to be a fantastic programme. I know you’ve put a lot of thought and work, with other colleagues, into the development of the programme and into its delivery. I’m really looking forward to participating, and thanks again for all the work you’ve put into it. OK. Well, it’s been a pleasure to talk with you, Brian. Thank you. And you.
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Thanks, Andrew.

In this video, Professor Cooper talks with Brian Rock, Director of Education & Training and Dean of Postgraduate Studies at the Tavistock and Portman NHS FT. They discuss why this course matters now and what led each of them to become interested in this area.

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Grief, Loss, and Dying During COVID-19

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