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Factions of a Mind: Understanding the physical and psychological effects of caring

Factions of a Mind: Understanding the physical and psychological effects of caring

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Factions of a Mind: Understanding the physical and psychological effects of caring

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Sep 7, 2020


In suffering the unexpected loss of her husband in the space of three months, Maria has navigated this passing into an honest awakening to the stages of grief. She explores the changes to one’s character, its effects on those around them and the difficulties we face as carers when confronted with the responsibility to manage and comfort our loved one in this process.

In Factions of A Mind, Dr Katsarou-Makin examines our role as the carer, learning how to manage the responsibilities as well as the suffering and pain that comes with it, thoughtfully and honestly discussing our duty to care. As carers, our obligation to ‘care’ for the other has inexplicably meant that we do not equip ourselves with the tools and resources to ‘care’ for ourselves after their passing. Our inability to comprehend their loss and the stages of grief we are experiencing leave us vulnerable and open to further pain.
Sep 7, 2020

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Factions of a Mind - Maria Katsarou-Makin


Written message exchange with a close friend on 26 August 2019:

And that is why I wrote this book. I didn’t just lose my husband: I lost part of myself. I was never the same after this experience. I was changed forever.

The same friend, Christina Themelis, wanted me to include the following in this book, as it’s how she viewed and experienced me during this time:

Observing Maria’s strength and perseverance gave a new perspective on my friend’s capabilities, regardless of circumstances. Headed to conquer her dreams, her world was shattered to the core.

On the verge of losing what she loved most, she stood strong, generating strength for both herself and her departing soulmate.

She refused to let go of hope, while acknowledging the reality of the situation at hand.

Her priority was his comfort, her breakdowns were with no audience, she fought strong and hard for both, knowing the battle would continue for her long after he was gone. Her strength is undeniable but remaining a loving, giving friend to all throughout is exceptional.

This is a book that doesn’t just focus on the patient. It mainly focuses on the carer, the emotional turmoil one goes through before, during and after death, as well as how to deal with death, how to deal with the subsequent new realities and how to come out of this as a different person who has not been broken irreparably.


The hospice where Geoff stayed organized what they call a ‘Time to Remember’ service. I received an invitation to attend, which I immediately accepted. Until the last minute, though, I didn’t know if I wanted to go. It was so cold and with the time change, it was already pitch black, making it all a bit harder. I finished work and told Jojo (our dog) we were going. I packed his treats and a big fluffy blanket and off we went. I could drive this journey with my eyes closed and didn’t even need the GPS.

It all came back: the last time we drove there it was dark because it was around 4am, and we were going to say goodbye to our Daddakouli (that’s what we would call Geoff). Tonight, we were going to let Geoff know we were still here, the two of us.

This time last year, we were four – my three hairy bears (Geoff and our two dogs) and me. And now, here we were as two. I didn’t know what to expect from this event. We went in, saw familiar faces at the reception, bumped into a couple of nurses we hugged really tight. And we cried. I even saw the lady from the kitchen who would take Geoff’s order and smile and roll her eyes when Geoff would ask for the crusts of his breakfast toast to be cut off.

The service was only 30 minutes long, and we could light a candle if we wanted. I had been wanting to light a candle since Geoff’s funeral because, even though I am not religious, there is something comforting about lighting a candle. At the end of the service, I asked for permission to walk around the rooms. I needed to see and be where he was the first time, the second time and where he took his last breath. All three rooms were occupied, so I could only stand outside. Part of me wished I could see him and just lay next to him, hold him and smell him, and fall asleep next to him. Another part of me didn’t want his suffering to continue anymore.

I am glad I went to the service because I needed to reconnect with that place, and I needed to go through this phase, not bypass it, not avoid it. I have found that the only way to adapt to this new way of life is to take a deep dive into the waves of my sadness, my feelings of loss, desperation and all other emotions. I find grief almost a necessity as a process that needs to be lived and not avoided. If I try to suppress any emotion, it comes out with a vengeance at the most unexpected instance. If you allow the process to take its course, it seems to be more controlled – not less painful, but more controlled.

Allowing yourself to feel these emotions has nothing to do with weakness, and not feeling the grief is definitely not a sign of being strong or managing it. So, it is not the pain of grief that may damage a person, but what you may do to avoid this pain. And this is why you need the support of others, and others need to allow you to grieve. There is an abundance of research showing that unresolved grief may lead to psychological and physical issues. Acknowledging the pain and learning to live with it is what will lead to eventual healing. Yes, it is hard work, but it will also change you. You will never be the same person you were, simply because you cannot unknow what you now know. Following the natural process and your own personal timing and pace, your grief will lead you to heal and grow from what you went through.

I am hoping that you will find some comfort when you read the following pages, similar to the comfort I feel when I light a candle or look at the robin that keeps reappearing in my back yard.

I feel all shadows of the universe multiplied deep inside my skin. – Virginia Woolf, from a diary entry dated 5 November 1931

I look in the mirror and all I can see is a young old person without a gender. My facial expressions and lines are rough. My left eyelid has a double folding, a sign of extreme stress and exhaustion. I am full of bruises on my arms and legs from trying to lift Geoff and holding him at times so that he didn’t fall, or trying to help him to his bed or chair or the toilet. I am pale with grey roots, with facial and body hair growing in places that I didn’t even know existed. I have lost a lot of weight and almost all of my muscle mass. My back and knees hurt and the whole of my left side is in pain, so I can’t even sleep on that side. But I am alive. So, it doesn’t matter.

I have seen images that I will never be able to forget. I feel traumatized, literally and figuratively. I am looking at our pictures from all these years and keep bringing up the nice moments in my mind’s eye. But, from time to time, the ugly ones take over.

A friend of mine came over to visit and her son wanted to go to Anfield, the Liverpool football stadium, and so we did. When you register for the tour, they put one of those plastic paper bands around your wrist as proof that you have paid. When the tour finished, I wanted to take it off but I couldn’t. I immediately went into panic mode, asked her son (as calmly as possible) to tear it off my wrist. My anxiety was increasing more and more, and I couldn’t hold back my tears. It reminded me of the last couple of days at the hospice when Geoff was agitated (which is a symptom of the phase of when one is actively dying). He was wearing, as all patients do, his wristband with his ID, and, in childlike movements, he was trying to take it off but couldn’t. He didn’t even have 100% contact with his surroundings and I could see him struggling, trying to run away from death. There was that part of him that was still fighting. My friend and her son had no idea that this was going through my mind or that I was almost having a panic attack. I had to cover the wristband with my sleeve, and I don’t know how I drove back from Liverpool to Frodsham that day. But it doesn’t matter, because I am alive.

The grieving process, they say, has stages, usually seven. Here is the thing, though. It’s very different if you lose one of your parents at the age of 80+ because the hierarchy of life is preserved. It’s natural that your parents will eventually die before you. It’s painful, but it is still the natural cycle of life. But it’s a totally different experience when you lose a person at the same hierarchy as you, and it’s again very different if you lose them of old age, after having spent a many good years together versus if you lose them after just five years. And the worst case is when you lose someone who is below you in the hierarchy, such as a child.

Within five years, I changed three countries, moved four times across countries and within countries, ran a successful business and started another two ventures. I also got married during this time and became a widow within four months. As Geoff would say, Shove it all in … maximize the time. Well, we certainly maximized our limited time.

I lost my life partner, my business partner and my best friend. All of our plans will now never materialize. We will never visit the places we said we would, we won’t have that really huge Christmas tree he wanted to have in the hall … nothing will be the same.

So, I don’t know whether the stages of grief are seven or eight, and it doesn’t matter because each person grieves in their own way. There is no right or wrong way. It’s just what you want and what feels right for you at that moment.

During this period, you will hear a lot of ‘words of wisdom.’ Everybody has positive intentions, but what they offer is from their own perspectives, and what is right for them may not be what you want. There will be moments when you will want to be on your own and moments when you will want to share your grief with your loved ones. One day at a time, one moment at a time.

Geoff was the kind of person who had an aversion to doctors and never had a blood test or any other health-check in his life. A smoker since he was 13, as an adult he would smoke about 60 cigarettes a day, the epitome of a chain smoker. He eventually cut down to 40 and, when I met him, he was trying to get it down to 20. But he was an extremely active man as well, always with ants in his pants to do something. I would really have to negotiate with him to have time to switch off, to sit in the garden, watch a movie or just ‘be’ with a cuppa. He was a very strong man, doing jobs that would require a lot of effort and strength, from chopping wood to climbing on roofs or trees. He had an extreme work ethic and was also a perfectionist – not in theory, but in practice. Those who have worked with him know very well what this means.

In his early days back in the 1980s, while he was still running Bacchus (his interior design and exhibitions company), he would go into the office before everyone else to turn on their computers so that when they came in, they didn’t waste time turning them on. Every minute had to be productive, and every job, big or small, had to be executed in the immaculate ‘Makin way.’ We were total opposites in that regard.

While we were living in France, he got ill of pneumonia three times in two years. The doctors there prescribed amoxicillin, and within ten days Geoff was up and running again. It was a concern (more to me rather than him) as to why he could be so vulnerable and in such a short period of time, but he would put it down to the wet and cold climate of France, his not-so-great nutrition (no fruit and vegetables) and his smoking. It was interesting (to me) that he never spread his

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