Mother's Day, again

Mother’s Day--I tell myself that it is a made-up holiday.  That it is just a way to sell cards, flowers, and help the restaurants make more money.  But—the build-up for Mother’s Day seems to be all around me.  It is in every advertisement I see for almost any product—“Buy your mom drain cleaner for Mother’s Day.  She will thank you.”  Okay, so maybe not, but it seems to be so prevalent.  With it goes my thoughts that I “use to be” a mother.  It was the best job I have ever had.  I took such pride in being a mom.  I only had one kid so I had to do it right the first time—and boy, I felt like I did.  Maybe I was too proud, maybe I bragged too much, maybe I shouldn’t have been so happy…

Now I only have the memories of being a mom and the knowledge that I will never hear that name used for me again.  I’m not someone’s mom, I won’t be someone’s mother-in-law, and I won’t be someone’s grandma.  So I have had to re-invent myself because for 24 years I had defined myself by that term-Mom.  When it was taken away from me I didn’t know who I was any longer.  Even when everything else in my life was a mess I still had that.  I tried to remember who the person was before I became a mom and it was impossible because I had been a mother, and I had lost a child, and it had forever changed me.  Then only eleven months after I lost one identity—that of mother—I lost another identity, daughter, when my mother died.  I was always very close to my mom, being the youngest child and the only girl.  I loved that my son had such a special relationship with my mom.  In less than a year they were both gone and I could no longer define myself as mother or daughter.  Who was I? Where was I?  I could not go back, I could only move forward.

Most of the time I am able to make the steps and move forward, but there are these little things, reminders of who I use to be, that all seem to happen for me around the same time.  These “anniversary reactions” pile up and I work harder at making the steps, one by one.  First in April was the anniversary of the crash, now May brings Mother’s Day, the beginning of next month is my son’s birthday.  Then for a while I will have some rest from these triggers.  When fall comes I begin new ones that carry over into the holidays.  It is the way my life is now and I mark the passage of time by these anniversaries and then take another step forward. 

Grief Journey--Then and Now

I have been so busy lately and focused on the practicum (pre-internship) for my Master’s in Mental Health degree.  I have begun the real work in the real world of counseling and it has been taking my time during the day working with clients and the evenings researching my work.  Because of this I have been neglecting the blog.  I have thought of it daily and regretted not being able to give it the attention it deserved.

As I was thinking about my life now having finally finished all my coursework, and I am now actually working as an intern in my field, I marveled at how much things have changed in the seven years since my world was turned upside down.  I wonder sometimes if my son would recognize the person that I have become.  His untimely death, followed by the death of my mother changed me profoundly in every way—physically, mentally, and emotionally.  Their deaths and the grief journey that followed shook my foundation apart and eventually I began building a new foundation, a different foundation based on what I had learned from this journey.

In those early stages of grief I never thought I would function again, have a life or a future.  I felt as if my life had ended that April day when my son died.  Shortly after I started seeing a grief counselor she recommended the movie, “Four Weddings and  a Funeral.”  I reluctantly watched the movie, not really able to concentrate, but I was struck by the poem read at one of the funerals.  It fully captured how I felt at that time.  I wanted everything to stop—for me, my world had stopped and I couldn’t understand how the Earth could continue to rotate on its axis. I would never have been able to tell that “me” who was so caught up in grief that  this “me” would come to a point in time that I was so busy with life that I would find that I was juggling to find time to do everything I want to do.  The journey continues, there are moments when the grief takes my breath away, but I move forward.

An interesting side note about the author of the poem, W.H. Auden wrote Opera librettos and the second version of the poem with the added stanzas was written to be sung by a soprano set to music of Benjamin Britten.  My son, Robert would be pleased about the opera connection.
I am sharing this poem with you below:

Funeral Blues by W. H. Auden

Stop all the clocks, cut off the telephone,
Prevent the dog from barking with a juicy bone,
Silence the pianos and with muffled drum
Bring out the coffin, let the mourners come.

Let aeroplanes circle moaning overhead
Scribbling on the sky the message He Is Dead,
Put crepe bows round the white necks of the public doves,
Let the traffic policemen wear black cotton gloves.

He was my North, my South, my East and West,
My working week and my Sunday rest,
My noon, my midnight, my talk, my song;
I thought that love would last forever: I was wrong.

The stars are not wanted now: put out every one;
Pack up the moon and dismantle the sun;
Pour away the ocean and sweep up the wood.
For nothing now can ever come to any good.

Trips and Triggers--Grief Revisited

I have written in previous posts about the unexpected wave of grief that can hit at any time caused by a sight, sound, smell, or taste that reminds us of a lost loved one.  Sometimes a news story can be the cause of the swell of sadness and tears.  I know that I am particularly aware of this grief trigger whenever I hear about the death of a college student and any small plane accident will send me to that place of overwhelming sadness.  I have learned to move quickly through the news channels and browse over the news articles on the computer, but sometimes there is no escaping the story and I trip over the inescapable edge of grief and the resulting emotional ride.  My thoughts will go to the parents and family of the victim because I know the life-changing event that has now catapulted them into a “club” that no one wants to join.

It has helped me over the years to understand that triggers can happen and that if I accept the emotions and breathe, it doesn’t last forever.  For those new to grief it can be an upsetting and unsettling experience but it is important to know that it is normal.  It is also an individual experience as everyone will be affected differently and be triggered by different events/things. 

Also some things that originally were triggers will fade over the years and no longer hold the power that they once did.  In the first years after the death of my son I could not have his picture displayed in my house, now I have a photo of him in just about every room.  I also had difficulty listening to some types of music and this could cause a trigger of grief even when I went to stores or restaurants.  I am less affected now and although I still choose not to listen to certain types of music if it is playing in public places I am able to dismiss it and move on. 

After almost seven years I have learned many of the things that will trigger my emotions but as is the case with memories I can’t always predict what will produce the tsunami of grief.  I have learned to ride out the storm and over the years the good memories have made me stronger.  I know that I will end up back on shore and able to walk forward again, one step in front of the other.

Easy Self Care While Grieving

When people are grieving it is easy to forget to take care of themselves.  In fact that is probably the last thing on their minds.  Often there is an aspect of survivor guilt that may cause them to be even harder on themselves and believe they don’t deserve to be well and healthy.  Unfortunately without a healthy body, the mind can not function effectively in order to do the work required for your grief journey.  This is the point when people may turn to unhealthy habits and addictions to numb the mind in order to stop the pain of grief.  As I discussed in my previous post, doing this just delays the inevitable because the grief is still there when the behavior stops.  As promised, here are some easy, healthy choices to take care of yourself.

BREATHE. Simple, right?—you are doing it right now.  Not necessarily so simple.  When stressed, people tend to breathe shallowly or hold their breath.  This causes less oxygen to get to the brain and through the body and can make you feel tired and generally un-well.  One early symptom seen in many grieving people is deep sighing, this is also a symptom seen in individuals with stress and depression.  Sighing is caused from dysfunctional breathing.

Learning simple breathing techniques that oxygenate the brain and body help to alleviate stress and make the brain work more efficiently. The easiest breathing exercise is done while sitting comfortably in a chair or on the floor, begin by purposely taking 10 deep breaths while inhaling through the nose and exhaling through the mouth.  Make sure that you don’t do them too fast because you can become light-headed.  There are many other breathing exercises, including belly breathing that I explained in a previous post, Grief and Mindfulness-Part Two.  This easy example is to return your awareness to your breath and increase your oxygen intake.  You can stop anywhere you are and practice this breathing technique.  It can calm you and center you when you are feeling especially stressed or experiencing a wave of grief symptoms.

TAKE A WALK.  I know, another one that sounds so simple, however when grieving the body and mind are weary and it takes resolve to make the decision to move.  Once you do get moving, a brisk walk increases the dopamine and serotonin in the brain which are natural neurotransmitters that create a sense of well-being and relieve sadness.  In addition the stress of grief can increase the body’s production of cortisol that produces the unhealthy fat that accumulates around the middle section of the body and walking can help to combat that.  If you are able to walk in the park and enjoy the sights and sounds of nature it will be even more relaxing and can keep you in the present moment and out of your thoughts for a little while.  Just a brief 20 minute walk can improve your mood and get some physical exercise into your day.

DRINK WATER.  Yeah, another simple one.  Many people forget this basic need to re-hydrate.  The body reacts in negative ways when there is a fluid imbalance.  Without the proper amount of hydration the body can become overheated, have low energy levels, and be subject to muscle cramps. Get out that pitcher in the back of the cupboard, fill it full of water, ice, and lemon if you like, and make it a point of filling up a glass to have by your side all the time.  You will be surprised how much more you will drink when it is right there.

None of these examples are rocket-science.  They are simple, self-care but they are extremely important to your well-being.  Grief is hard work so you have to keep your body and mind in shape in order to do the work.

Remember—breath, walk, water—and be kind to yourself.

Death and the English Language

After experiencing grief I was interested and surprised by the number of times that death, dying, and killing came up in daily expressions that had nothing to do with the actual subject of losing one’s life.  I think I became more sensitized to the words and even to the gestures people use.  I worked with someone who when work stress got to be too much would shape his hand like a gun and put it to his temple and pretend to shoot himself.  It always bothered me. 

I also have a problem when people pretend to slash their throats.  For most people this means nothing more than an expression of frustration but to me I think about the consequences.  Maybe I am way too sensitive to the whole thing.  It is just humorous that the same people who won’t talk honestly about death and dying are the first ones to pepper their daily conversation with terms like “I could kill you,”  “I could just die,”  “You’re killing me,” “I feel brain-dead,” or “I’m dying of thirst.” 

Comedians, after a good set will say they “killed” the audience and the audience may say they “died of laughter.”  Even at work we have “deadlines” or we become “deadlocked” on an issue.  We all have been guilty of “killing time.” When driving we can come to a “dead end.”  Who doesn’t hate it when they hit a “dead zone” and can’t get phone service?

 

One of these expressions has always bothered me, even before my experiences with grief.  It is the use of the term “drop dead” aimed at someone who has made you upset or angry.  I always felt like it was tempting fate or enacting a curse to use that term.  I know that seems superstitious, but I just know from being on the receiving end of that term it stings to know that someone would hate me enough to want me dead.  I also think that “scared to death” and “worried to death” are thrown around in passing without a thought.  The truth is that trauma, worry, and anxiety can kill. 

Okay, so maybe I am taking this all too literally and I need to lighten-up.  I don’t know.  It still makes me a bit uncomfortable when I think of someone being “dressed to kill” who goes on a blind date with a “lady killer.” 

Perhaps we use these terms so easily and frequently in an unconscious attempt to lessen the hold that death has on every human.  It just seems like it would be easier to live with the reality of death than to beat the idea to death.  What?  Oh, I just did it didn’t I?

Remembering My Mother

Today is my mother's birthday.  She would have been 95 years old.  She died ten days after her 89th birthday while in hospice.  I miss her gentleness and love. She and I would talk on the phone almost every day until my son died eleven months prior to my mother's death. 

When my son died my mother felt like she was losing her only daughter in addition to her youngest grandchild.  She was desperate to make me “better.”  Whenever I would call her she would ask me how I was feeling and that would lead me to tell her the truth, I was feeling rotten.  She couldn’t accept this and would tell me that I needed to get through this because she needed me.  It became more difficult for me to talk to her because of these exchanges and I began to call her less often and distanced myself from her as I suffered from the severe grief of losing my only child.

My mother was diagnosed with terminal cancer at the beginning of 2007, just months after my son’s death.  I felt like I had not been doing my job of taking care of her like I always had---taking her to the doctor and making sure she had the things she needed.  I had given over these duties to my brother and his wife because I was just too exhausted from my grief and didn’t feel like I could handle any additional stress.  When I found out that my mom was terminal I took over and made sure that she was comfortable at the hospital and then eventually in hospice.

I stayed with her most of the time and we talked, laughed, and cried.  I would take in photo albums; we would look at the pictures and tell stories of our family and of course memories of my son.  At one point I was sitting in my mom’s bed with her and she told me this was just what she had wanted—for us to be together and talking like old times.  I was so happy that I was able to be there for her and for me.

Her death taught me what a “good” death was like.  She had lived a long life and she was ready to transition to the next phase.  She was able to have a gentle death and we were then able to give her a well-planned and loving memorial service. 

Although I miss her in my life, I am so grateful to have had the honor to be there to help her when she was facing death.  It showed me that death can be a welcomed event for the dying and that it is a privilege to be able to assist someone in his or her journey.

I love you Mom.

Grief Metamorphosis-Choices, Changes, and Adjustment

I read an article this week from a minister who works with individuals experiencing grief.  I was interested in his explanation of the work someone must do on his or her grief journey.  Troglen stated that rather than the term grief “recovery” he preferred the term grief “adjustment.”  I have to agree with him.  

The Merriam-Webster dictionary defines recovery as “the process of combating a disorder or perceived problem” and “regaining or returning to a normal or natural state.”  Although grieving can feel like combat sometimes, most individuals would agree that they do not return to their original normal or natural state that they were in prior to the death of the loved one.  One of the 
dictionary definitions for adjustment is “a correction or modification to reflect actual conditions.”  I think that more accurately reflects the process of grief and healing in order to modify or change themselves in order to reflect the “new normal” of life after the loss of the deceased.   

Sometimes death is likened to the metamorphosis of the caterpillar to a butterfly.  I have also seen this metamorphosis analogy applied to the grief journey, adjustment and healing.  A grieving individual is changed slowly from the person they had been (the caterpillar) to the chrysalis stage where the grieving person is in the healing cocoon before they are able to emerge on the other side of the process as the changed or adjusted person (the butterfly).  Although this could be looked at as a change (from caterpillar to butterfly) I think of it more of an adjustment necessary for survival.  In this respect I see the analogy working well with the definition of grief adjustment rather than recovery.



When a griever is faced with the daunting task of working through the changes that need to be accomplished in order to choose to come through the grief journey and heal it may seem insurmountable.  The key is in understanding that although the experience of death may have happened suddenly and quickly the work to be done to grieve and heal will take time.  It is with this understanding and self-acceptance that the grieving person can begin to build the foundation that will allow for successful adjustment and a new chapter in that individual’s life.  It takes time, tears, and tenacity but the choice is worth it.  Remember the work the caterpillar has to accomplish in order to gain the beauty and majesty of the butterfly.

This Is Your Mind on Grief--Cognitive Changes

Two of the symptoms of early grief are difficulty with concentration and memory problems.  In my case I also experienced trouble finding the right word when talking.  The difficulty with concentration can prevent a grieving individual from being able to read a paragraph from the newspaper, watch a television show, or attend to daily responsibilities.  Memory problems can range from misplacing keys to forgetting what had transpired the prior day. 

When speaking, the grieving individual may have trouble articulating as well as they use to and when they are aware of the problem it can become a source of embarrassment and worry.  Many individuals suffering from these symptoms, including myself, wonder if there is something seriously wrong with them and if the changes are permanent. There have been research studies that have shown neurological and immunological changes may be involved in how individuals respond to grief.  There is also speculation that permanent changes in brain structure may happen like those that have been seen in individuals with major depression.

Next month will be the 7^th anniversary of my son’s death and as I reflect back on the first few months of grief I can see that the fear of never being able to concentrate again was unfounded.  I believe my concentration is as good as it was prior to my grief journey.  However I wonder about the other two symptoms.  I don’t have memory problems with current events or events prior to the accident but there are events in the first few weeks after my son’s death that I do not recall at all or only in pieces.  I think that may be a protective mechanism because my brain could not handle the trauma.  However I now wish I had a clearer picture of events such as the memorial service at the university and meeting with Robert’s friends and teachers.

I sometimes still have trouble finding words when I am speaking and this bothers me quite a bit. I have always loved words and enjoy verbal and written exchanges.  When I am speaking to someone and I can’t find the word I want to use, I will explain to the other person that this problem is a result of my experience with my son’s death.  As I get older I am sure that people have begun to think it is more of an age-related problem but I know that my brain was forever altered by the events of that April night.

I Didn't Tell My Son Goodbye and I'm Glad

The last time I spoke to my son was the morning before the plane crash that took his life.  He was in a hurry, as usual, so we talked briefly, we both exchanged “I love yous” and  he told me he would call me later.  He never did. 

Ever since that day I have trouble with any type of goodbye.  I sometimes wonder if that is a result of the loss of my only child or if it was the result of an experience I had early in my grieving journey.


Site of Plane Crash; Bloomington, Indiana

Shortly after my son’s death I went to see a grief counselor and she insisted that I write a letter to my son telling him goodbye.  She felt that this would be helpful. She believed that because of his sudden, violent death I hadn’t been able to say goodbye before he died like parents of ill children.  This was supposed to be an exercise to help me to come to terms with the loss and finality of his death.  It proved to be an awful experience for both the counselor and myself.  I was infuriated that I was told I had to tell him goodbye.  Although I realized he was gone and not coming back I refused to say goodbye, I wasn’t ready and I didn’t know if I would ever be ready—and that’s what I wrote.  This wasn’t well received by the counselor because I didn’t follow the “textbook” response to the exercise.  She and I argued over this issue as I tried to defend my position.  It was exhausting for me at a time when grief was already taking my energy—but I felt strongly about it and would not back down.  He was my son, my only child, and no one would tell me to say goodbye to him.

This experience and several other unfortunate experiences with other experts and first-responders was what convinced me that I wanted to become a counselor and to specialize in grief counseling. No one can tell you how to grieve; no one can take on the work of grieving for you.  You have to find your own path on your personal grief journey.   In writing this post I found online a story about a woman whose only son was killed by a train in 2003.  Maria Malin wrote a book about her journey, called “When You Just Can’t Say Goodbye, Don’t.”  Maybe I should send a copy to that grief counselor.

Stop the Presses--The Misuse of the terms Grief & Bereavement

In last couple of days I have noticed the words grief and bereavement used in headlines of stories on the internet that had nothing to do with death.  I understand that with many major losses such as job loss, dissolution of a relationship, or a traumatic event there are similar feelings related to grief symptoms.  However the use of grief and bereavement in these two instances bothered me. 

The first instance was titled, “Church is in Bereavement over Pope.”  In the author’s defense the title was taken from a quote from Auxiliary Bishop Charles Sicicluna who said, “The church is in bereavement, coming to terms with bidding Benedict XVI farewell and waiting for his successor.”  I understand this historical significance of the Pope deciding to step down but I can’t see the choice of the word “bereavement” to explain how people are feeling about this change.  There is no death, no loss, only a change in the head of the church made by the Pope’s own choice.

The second instance was titled “Grief and Organizational Change” and uses the five stages of grief to discuss changes that happen in business and how to deal effectively with them.   This one was particularly disturbing to me.  I then did a Google search on Grief and Organizational Change and found over 175,000 results including a book published in 2009.  I find it interesting that people writing about business would want to use the bereavement comparison when business is so unsympathetic to employees who are bereaved.

The reason for pointing out these two instances is to say that in our culture where grief and bereavement are so misunderstood and sometimes swept under the carpet the use of these terms for other purposes tends to dilute the definition and does a disservice to the people who are suffering through their own grief journey. 

Two fathers started an initiative, the Farley-Kluger Initiative, in 2010 determined to amend the current Department of Labor FamilyMedical Leave Act (FMLA) to include bereavement leave for parents when their child, up to age 26, dies. 

At the present time the FMLA is a federal law that requires companies with 50 or more employees to afford their employees 12 weeks a year of unpaid time off for their serious health condition or that of their children up to age 18, spouse, and parents.  It also covers the employee after birth of a child or adoption placement. There is also a section related to military leave.  

The two men who began this initiative are both authors of books about their own grief journey after the loss of their children.  Barry Kluger’s only child, his 18-year-old daughter, Erica was killed in a car accident in 2001.  Kelly Farley’s daughter, Katie, and son, Noah, both died in infancy within 18 months of each other.  Kluger’s the author of A Life Undone: AFather’s Journey Through Loss.  Farley’s book is called Grieving Dads: To the Brink and Back.

After both Farley and Kluger’s lobbying attempts in Washington D.C. there has been legislature introduced in the Senate and the House to make this amendment happen. Currently there is a bill before the Senate.  However Farley stated that he was informed that only about 10% of the bills introduced are ever approved.  The two men have started a petition campaign online in order to get the word back to the legislature that people want this change.

I have mixed feelings about this amendment.  As a parent who was in this position almost 7 years ago my first reaction is that this is a wonderful change and is something that every parent needs.  The early stages of grief after the death of a child are so chaotic and life-altering that an individual’s focus is all-encompassed on dealing with the symptoms of the grief.  As I discussed in my previous post about grief in the workplace there are problems with concentration and memory that affect the worker’s performance and the probability of triggers that cause crying is always there.  This 12-week leave would give the grieving parent time to get past the most critical and intense grief period. 

However I am concerned about the employee whose spouse or parent dies.  These employees may have already been on an FMLA leave caring for the ill spouse or parent and once the death occurs the employee is no longer eligible for FLMA, has only the company’s bereavement time available (usually 1-3 days) and then must return to work.  This can be an awful predicament for an employee who is exhausted from being the caregiver for their loved one for weeks, has been experiencing anticipatory grief (I will discuss this in detail in a future blog) and is now in the full throes of early grief symptoms. 

Then there is the employee whose spouse dies unexpectedly leaving them with young children who are themselves grieving or the employee whose spouse had handled all of the household business and now the employee has to take over all of these responsibilities.  Both of these scenarios require concentrated time for the employee to be able to bring his or her life to a new normal and FMLA bereavement leave would be appropriated in these cases too.  Just as no one grieves the same, no loss is the same.  There is a general consensus that the death of a child is one of the most devastating losses and having experienced it personally I would have to agree.  However I also appreciate the fact that the initial grief after the death of a spouse or beloved parent can be a devastating blow. 

So, should this amendment be only for parental bereavement leave or be opened up to include the same criteria that the original FMLA covers and include spouses and parents?  In my opinion it should include these loved ones.  Most employees can not afford to take time off without pay therefore I do not believe that this will be an overused leave option which is the fear of opening it up to more reasons.

I would be interested to hear other people's opinions of this change in the FMLA.  What do you think? 

10 Things You Should Never Say to a Grieving Person

Most people don’t have a clue what to say to a person who is grieving.  They find it awkward and uncomfortable because they are dealing with their own emotions related to death and immortality.  What they say can have a profound effect on the grieving person and can be remembered by that person for years.  The best advice is to just say, “I’m sorry” and leave it at that.  It is better at this time to allow the griever to do the talking and be a good listener.  They will appreciate you so much for that!  A hug can say much more than words and is harder to misinterpret.

Below are ten examples of things that were either said to me or have been said to other grieving people who have shared them with me.  The comments below the examples are there just to get you thinking and start a conversation.  Some of the comments may seem trite, or tongue-in-cheek, or a little rude, but sometimes that is how a grieving person may feel at the moment.  I hope this helps you think before you speak the next time you are in front of a grieving person.  If you are the grieving person who is confronted by one of these statements perhaps you will reflect on the fact that the person is reacting and not thinking and this might help to soften the blow a bit.

I’d love to have you join in the discussion and send me other examples that you have experienced first-hand.

1. I know just how you feel.

No you don’t.  We are different people.  Everyone grieves differently and every relationship with the deceased loved one is unique.  You can’t know how I feel, but you can ask me how I feel.

2. You are so strong.  I could never live without my ___________. (insert--child, spouse, partner, mother, father, etc.).

No I’m not strong.  In fact I have never felt more weak or confused.  I don’t know what else to do but move through this nightmare.  I didn’t have a choice.  Telling me I’m strong makes me feel more confused.

3. God only takes the best.  He must have really needed him/her.

I really needed him/her more.  I wish he/she wasn’t the best and was still here with me.

4.  It’s been… 2 days, 2 weeks, 2 months, 2 years.  It’s time for you to get over it and move on.

There’s a timeline?  No one told me there’s a timeline.  I don’t feel ready, so I’m not ready. 

5.  Don’t cry. He/She wouldn’t want you to be sad.

Really?  I don’t think we ever had that conversation about how to act after one of us died.  I think not crying would be worse.  I have to be able to express my feelings and I think he/she would be proud of me for doing that.

6.  It’s time to give away his/her stuff.  You can’t keep it forever.

Again with a timeline?  Why can’t I keep it forever?  As long as I am making strides forward in my life there’s nothing wrong with keeping my memories of this person who was so important in my life.

7.  You ought to…move out of your house, go on vacation, start dating, get out more.

If my loved one hadn’t died would you be giving me this same advice?  Why do you think it’s ok now?  I can’t make these kinds of decisions right now.  Give me room to breathe.

8.  You should get a goldfish, kitten, puppy.  You should have another child.

I am having trouble taking care of myself right now.  I can’t remember to water the plants and you want me to take on another responsibility?  Oh, and by the way, another child isn’t a replacement.  It’s not like buying a new car.

9.  Can I have his/her car, clothes, sports equipment, books, music collection…?

Um, no. 

10.  Everything happens for a reason.

There was no reason for this.  I can’t believe this.  My loss may eventually have meaning in my life but it didn’t happen for a reason.  Death happens, just like life happens.

Walking the Grief Maze

Grief is probably one of the oddest and unsettling experiences that the average person goes through in their lifetime.  There is nothing logical about the symptoms or the length of time each person requires to adequately grieve the loss.  The griever worries that something is wrong with them. The people around the griever encourage this attitude by benchmarking grief and measuring the experience.  Too often a grieving individual is told that it’s time to get over it.  When the greiver internalizes this and isn’t able to meet the mark he or she may feel ashamed and guilty.  These feelings on top of the grief are a lot for anyone to handle. You can not try to think your way out of the grief, or place blame on yourself for not progressing. 

The term grief journey is used often and for a good reason.  It’s not a single episode or a few days of public mourning.  This is a journey on a path that hasn’t been traveled before.

I think grief is more like traveling through a maze.  You begin to walk the maze and come to a block, you may have to turn around and go back over your steps and start again, you walk around and around the maze confused and anxious.  Sometimes you think there is no way out of the maze.  Occassionally you meet a fellow wanderer and the two of you can work together because you are experiencing a similar maze.  However in the end the maze is yours to explore and walk through until eventually you find your way out.  You never forget the maze and the changes walking it has made in your being, but you move on putting one foot in front of the other.

7 Signs of Complicated Grief

Part 2 of Could It Be Complicated Grief?

Now to the 7 signs of Complicated Grief.  This is just a brief list of what I consider the most serious signs that should warrant at least a consult with a professional.  There are more signs (symptoms) that you can read about on the Mayo Clinic site.

1) Suicidal thoughts or actions

One of the most alarming signs of complicated grief can be suicidal thoughts or actions.  This is different from the thoughts in uncomplicated grief of wanting to join the deceased love one or wishing to change places with the deceased in order for them to live.  This is not a sign that should be taken lightly. If there are ANY concerns regarding suicide ideas, plans, or attempts—DO NOT WAIT—contact someone immediately.  Suicide is one of the top causes of death in the U.S. and most people will tell someone about his or her plans within days of the event.  It is better to err on the side of caution and save a life.  NationalSuicide Prevention Lifeline 1-800-273-TALK (8255)

2) Depression or unrelenting sadness

This is not the initial sadness when thinking about the deceased loved one.  This is a deep sadness that you can’t shake after many months that affects every part of your life and isn’t getting better.  Depression is often a complication of complicated grief and may require professional support and treatment.  Often in our society we say we are “depressed” when what we mean is that we are sad or upset about a singular event—this is not the same thing as a true depressive disorder.  If you aren’t sure what you are feeling is depression you can consult a professional who can do an assessment with you to help you to understand what you are feeling.  Depression is treatable with either talk therapy or behavioral therapy to change the negative or faulty thinking that lead you to be depressed and keeps you there.  In addition there are medications that have been found to be effective in treating some forms of depression.  The National Institute of Mental Health has a website with a great deal of helpful information about depression and where to seek help.

3) Life is No Longer Enjoyable

This sign is often associated with depression as many of the signs/symptoms of complicated grief do overlap with depression symptoms.  For this sign the person suffering from complicated grief may feel like they will never feel like they did before and are merely putting one foot in front of the other as they trod through each day.  Activities and people that they use to enjoy no longer have that same feeling.  If asked, the individual would find it practically impossible to name anything they would want to do that would bring them joy.

4) Withdrawing from Social Activities

As the time goes by after the death of the loved one and other people continue on with their lives, the person with complicated grief may feel like they are alone in their grief and that they are the only one who still cares about the loved one.  This also makes the person feel like the world around them is foreign to them because they no longer no how to act/react in public situations.  These feelings along with the feelings of depression will keep the person from wanting to participate in social activities and lead to isolation.  This becomes a dangerous loop because isolation makes it more difficult to move beyond the constant thoughts about the loss and therefore keep the person from venturing out into the world.

5) Bitterness, Anger, Irritability, Agitation

There is often guilt and anger surrounding the death of the loved one, especially if this was a violent death.  These negative feelings are not assuaged by positive feelings and just feed upon each other and this leads to the irritability and agitation that the person with complicated grief experiences. 

6) No Hope in the Future

The person with complicated grief cannot imagine a future without the loved one in it.  Trying to think about a future like that can bring on feelings of guilt and anger.  This can further exacerbate the depressive feelings and make the individual feel hopeless and helpless.  Without meaning or purpose for life the individual can see no future and is incapable of hoping for a different future without the loved one.

7) Difficulty handling normal activities and routines

When there is no hope or meaning, the individual has trouble accomplishing even the most routine activity.  It can be rough for the person with complicated grief to take care of their needs, to handle daily chores, or to concentrate enough to hold down a job.  Some people will look from the outside as if they are coping and handling their responsibilities adequately but enternally the person is struggling to just keep up.

Once again I would like to mention how important it is to know the signs of complicated grief in order to seek out treatment to prevent more serious psychological or physical disorders.  In addition I want to reiterate this post and the previous post were strictly informational and that I am neither a psychiatrist nor a medical doctor.  I have provided links to well-known and respected sites if you would like more information on the subject. Whenever there is any question about an individual’s well-being a trusted member of the medical community should be consulted.

Could It Be Complicated Grief? Part One

This is Part One of a two-part post about complicated grief.  This part will define uncomplicated grief and complicated grief and discuss the risk factors that may make someone more likely to experience complicated grief.

It is important to know the signs of complicated grief in order to seek out treatment to prevent more serious psychological or physical disorders.  However before discussing these signs it is important to note that I am neither a psychiatrist nor a medical doctor.  Whenever there is any question about an individual’s well-being a trusted member of the medical community should be consulted.

The Psalm tells us that there is “…a time to weep, and a time to laugh; a time to mourn, and a time to dance.” (Ecclesiastes 3:4, King James Version).  If we live long enough most of us will experience the feelings of grief when we lose a loved one.  It is socially accepted that after the death of a loved one that those left behind will participate in a short period of public mourning. It is pretty evident by the typical business policy for funeral leave of between 1 to 3 days off no matter the relationship of the deceased loved one that our culture expects people to “get over it” and “move on.”  However that isn’t the reality and private grief is veiled in mystery because it is different for each individual and the type of relationship that individual had with the deceased loved one. 

There has been research into “normal” grieving or better termed uncomplicated grief and the similarities in experiences among those grieving.  From this research and reports from the grieving individuals themselves there have been a loosely agreed-upon definition of grieving and the experiences of grieving (Bolen, P. A. & van den Bout, J., 2008, January 15).  With uncomplicated grief the grieving person begins to adjust to life without the deceased love one.  It isn’t a recovery but a process of changes and adjustment that now allows the individual to live a different life.  It can dramatically alter the person however they are able to find meaning and purpose and allow themselves to have hope for the future.

Some of the study results have shown that treatment or intervention for uncomplicated grief is not helpful and there are professionals who believe it is not only unnecessary but harmful to the natural progression.  My personal opinion is that grief is different for each individual and therefore options for support and treatment are individual and should be decided by the grieving individual. 

There are some people who may find grass-roots support groups, run by those who have also experienced loss, most helpful; others may find more formally-run bereavement educational groups, usually held at funeral homes, hospitals, and hospices, a good fit; and others may find talking to a grief counselor or mental health counselor something that is helpful and fits their needs.  There are other individuals who have family and friends’ support that don’t feel the need for other support but many people don’t have this type of support and may need to reach out to these other avenues of support.

Approximately 10% to 20% of all bereaved individuals will develop complicated grief (Lobb et al., 2010).  Complicated grief is sometimes called abnormal grief, chronic grief, or prolonged grief. Complications that can co-occur or happen during complicated grief are depression, anxiety, post-traumatic stress disorder, risks of heart disease, high blood pressure, and cancer.  In addition the individual may continue to struggle with coping with daily life functions and may also begin to abuse drugs, alcohol, and nicotine.

There may be some risk factors that can cause someone to be more susceptible to moving into chronic grief.  Some of these risk factors include when the death is unexpected, violent, or due to suicide; when there is a minimal support system of family and friends, when the individual had a close or dependent relationship with the deceased person.  In addition there are some characteristics that the individual possess that may predispose them to complicated grief, some of these characteristics include, trauma at a child including abuse or neglect, history of separation anxiety in childhood, difficulty adapting to life’s changes and lack of resiliency, and prior psychological problems.

References:

Lobb, E. A., Kristjanson, L. J., Aoun, S. M., Monterosso, L., Halkett, G. B., & Davies, A. (2010). Predictors of complicated grief: A systematic review of empirical studies. Death Studies, 34(8), 673-698. doi:10.1080/07481187.2010.496686

Next –Part Two--7 Signs of Complicated Grief