Dr Thomas Stuttaford
2 for 1 at Pizza Express

Former bankers, who once had hectic, crowded lives fuelled by excitement, large salaries and lottery-sized bonuses, are now filling their days drinking coffee in Notting Hill. Some apparently shocked, others seemingly unmoved, they scour the internet with BlackBerries to check contacts and gather intelligence about alternative jobs. Some are already irritable and dejected, drink too much in the evening and suffer a drunkard's false dawn as they awake sweaty and anxious at 2am.
Few people feel compassion for discarded bankers. They face grief and bereavement about loss of income, lifestyle, friends and status without sympathy. In contrast, lonely men or women deprived by death of the companionship of a partner of 50 or 60 years are able to receive support from family and friends who share their grief. Although the reaction to their plight is different, abandoned bankers and bereaved mourners are both suffering from the same psychological changes, but with symptoms of a different quality and impact.
Bereavement is the human reaction to the loss of someone or something that has been an integral, important and possibly all-consuming part of their life. The City man, with Jermyn Street shirt, Savile Row suit and Porsche, has had his psyche disrupted in a similar fashion, if to a lesser extent, to an elderly widow, widower or grieving parent. Divorce and debt, especially if it involves the sale of property and disruption of lifestyle, are other common instigators of a bereave-ment response. This can also be induced in sensitive people, although the grief will be less intense and of shorter duration, by the loss of a treasured pet or, more prosaically, a valued possession.
The standard initial response to grief is either shock or denial. A shocked person might seem dazed, disorientated and totally incapable of making decisions. They might be tearful or panicky. Conversely, those with feelings obscured by denial appear to be coping wonderfully well. Whether looking for a new job or arranging a funeral, their friends admire their stoical approach. During the initial acute stage a sorrowing relative is likely to be weepy and tearful. However, a banker would be unlikely to show emotions that are so alien to office culture, but could well be withdrawn, morose and silent.
During the acute phase of grief a sufferer might have illusions that the deceased person is still around and it is likely that he or she haunts the dreams of the bereaved. Similarly, a dismissed banker might still check share prices and pore over City pages, although neither will provide useful information. John Major recently said that after he ceased to be prime minister it took him about a year to remember that when he heard the Today programme on Radio 4 at 6am he didn't have to do anything about the latest crisis.
After a time, sometimes as little as a week or two but in other cases as long as two or three months, shock, denial and acute grief lead to anger, the second stage of bereavement. People angered by their loss, and the effect it has had on their lives, look for others to blame. Surely the doctor was incompetent. Were colleagues irresponsible and careless? Who was gunning for me? Which bureaucratic authority should have done more? The anger might be all-consuming and the desire for revenge so strong that it leads to costly court actions, seemingly endless inquiries and ruined reputations. Although grieving can stick at any stage, it often becomes fixed during the phases of anger or depression.
Usually within six months, anger and the desire to apportion blame and seek revenge give way to classic symptoms of depression. Irritability, feelings of hopelessness, loss of enthusiasm, guilt, inability to get started in the morning but with more energy later in the day are obvious features. Appetite, weight and sexual drive are lost, sleep is elusive and a change in drinking habits is apparent. Some depressed people drink to deaden the feelings of rejection and drown insecurities, but others forsake drink because subconsciously it is associated with happier times. Grieving people with a previously successful career frequently develop psychosomatic symptoms for it is acceptable to have physical but not emotional symptoms. Whatever else troubles them, grieving people become obsessed by their loss. The danger is that it is easy to attribute the depressive symptoms of grief to bereavement and to neglect a severe underlying depression that can lead to suicide.
Finally, after about a year, the depressed phase of bereavement begins to lift and the patient's mood moves to the stage of acceptance. By then a sorrowing relative or displaced City worker has learnt to adapt to the changes and begins once again to take pleasure in fresh interests and relationships.
I am old enough to remember seeing the dole queues of the 1930s, the dismay at the oil crisis and the collapse of the housing boom in the 1970s, and in the 1990s was involved in the resettling of the senior executives of a disbanded industrial group. In another ten years, the sorrowing widow and the disgruntled banker will again be buoyant.
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