Understanding Grief – an Interview with Linda Machin

Written by NSCCOctober 20, 2017
Research , Wade Conference Centre

Meg Jorsh speaks to bereavement theory pioneer Linda Machin about her groundbreaking research

Grief affects all of us at some point in our lives. When a loved one dies we may feel crushed, overwhelmed. Then it fades to a quiet pain that hides behind everything we do until we finally learn to live with it.

But for some of us, relief never comes. The waves of sadness continue to mount, so that everyday life seems tiny by comparison. For these people bereavement holds risks of its own – depression, anxiety disorders, substance misuse, sudden cardiac events and potentially suicide. They need professional help to adjust to their new way of living.

Unfortunately it can be hard to tell the difference between those treading water and those not waving, but drowning. It has been the life’s work of bereavement expert Dr Linda Machin to better understand the landscape of loss and the ways individuals grieve. Her pioneering research has helped countless professionals to understand grief and bereaved people to feel better understood.

“I think a lack of understanding can make grief longer-lasting than it needs to be,” says Dr Machin. “It can bubble along even worse for some people if they feel misunderstood and their care isn’t addressed appropriately.

“People who begin to grieve chronically can also become depressed and anxious, the ultimate potential risk is suicide. You only have to look at the media attention to Princes William and Harry and their comments about losing their mother to appreciate the long-lasting and persistent nature of grief. They were young people then but it can apply to people at any stage of their lives.”

Models of Bereavement

Dr Machin is best-known in her field as the creator of the Range of Response to Loss model and Adult Attitude to Grief scale. These psychological tools allow professionals to categorise a bereaved person’s  grief according to their levels of overwhelmed, controlled and resilient reactions. A more overwhelmed person may be so distressed they feel they can never be happy again, whereas a more controlled person may refuse to accept the reality of their loss. On the other hand, a resilient mourner may feel they are able to cope with their pain.

“The AAG scale is a kind of a triage system,” Dr Machin explains. “The interventions that are deemed appropriate are based on the scale. Some people who are very overwhelmed by their grief will need a very different intervention to someone who’s closed down on their grief but is still not coping.”

“NICE have produced guidance for bereavement intervention – the first group is one where people simply need signposting to practical advice and support from family and friends. The second is one where people do need some opportunity to talk about things that are troubling to them. Then the third are the group who are most vulnerable and are likely to need longer-term intervention by therapists.”

Further Research

The more recent development of the AAG scale to identify  vulnerability was funded by the North Staffordshire Medical Institute for research with two Marie Curie hospices (Hampstead and Belfast), the Dove Service bereavement support team in Stoke-on-Trent and the bereavement service of St Giles’ Hospital in Lichfield. It is now being used by a range of UK organisations including Marie Curie and Cruse Bereavement Care, as well as internationally by groups in Canada, Iceland, Portugal, Australia, Pakistan and the USA. Dr Machin is also working on a modified version for people affected by terminal illness.

“It’s  looking at the whole question of mental health and loneliness,” she says. “The ultimate aim is that this is a method that allows the practitioner to enhance their work with people as  they progress from end of life care  to bereavement.”

Dr Machin and her team, based at Keele University, received a £4,500 grant from the North Staffordshire Medical Institute in 2011.

For more information on the medical research charity or to make a donation, visit our website at https://nsmedicalinstitute.co.uk/. You can also like us on Facebook at @nsmedicalinstitute or follow us on Twitter at @nsccentre.

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Safer cannabis use a myth, North Staffordshire research reveals

Written by NSCCSeptember 7, 2017
Research , Wade Conference Centre

The North Staffordshire Medical Institute supports research in a wide range of fields – including substance misuse. We spoke to expert Dr Roger Bloor about his study of cannabis vaporisers.


If you believed the manufacturers, you might think that vaporisers were a safe way of using cannabis.

The smoke-free inhalers are sold as a harmless way of getting high without lighting up. They do allow users to avoid some of the cancer-causing chemicals in cannabis smoke – but it comes at a price, according to research funded by the NSMI. The vaporiser fumes do not contain as much tar, hydrogen cyanide and nitrous oxide as would be produced by a cannabis ‘joint’. But they do contain toxic levels of ammonia, putting users at risk of serious lung disorders.

Lead researcher Roger Bloor, a former psychiatrist and addiction specialist, explains: “Cannabis, which is illegal in this country, is very widely used but carries risks from things like tar, which clogs up your lungs and can cause all sorts of health problems.

“Some people devised a way of using cannabis without smoking it by heating it up on an electronic plate and that reduces the risk. We investigated and we found that it does reduce the tar, but there’s a massive spike in the production of ammonia when you use these devices. The type of level whereby if you were running a factory, it would be shut down as a public health risk.”

Ammonia, which is commonly used in agriculture as fertiliser, is a poisonous chemical that can cause blindness, lung damage or death when inhaled at high concentration. Large quantities were detected in cannabis vapour produced in the labs at Keele University and analysed with cutting edge SIFT-MS
technology. The study looked at popular vaporiser brands available online, including the notorious Blue Meanie and Volcano models.

“We used standardised cannabis, where we knew what was in it, and we also had a license to have any seized drugs sent to us so we had street cannabis as well,” says Dr Bloor. “Street cannabis contains far more ammonia than the farmed cannabis usually used for research. This is because ammonia is found in the buds of the plant, which street cannabis is full of, rather than the leaves.”

The original research, funded by a grant of just £4,869 in 2004, went on to inspire several follow-up studies and an article in world-renowned journal Addiction. It is regularly cited as a warning to those considering buying a vaporiser as a ‘safe’ alternative to cannabis cigarettes. The devices, which cost from £35 to £350, are still widely available from specialist shops.

Dr Bloor said: “People recommend them, and they recommend things like water pipes, to take out the high tars. There’s a whole industry producing things to technically reduce the risk from cannabis which people are keen to use, but the research into them is not complete.”

Even if the devices could make smoking cannabis physically safe, they would not prevent the risk of psychiatric side effects. “The major risk of cannabis is that it can trigger schizophrenia,” he adds. “The strong stuff can be highly dangerous, but with the lower-powered stuff most people use the main risks are physical.”

To find out more about the research funded by the North Staffordshire Medical Institute, like us on Facebook and follow us on Twitter. Please help us to support pioneering research projects by making a donation through the link to the right of this page.

 

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