Out of the Shadows-Talking about Death and Grief

I have mentioned in previous posts how people become very uncomfortable around grieving people.  Oh, they can accept the prescribed amount of public mourning but after that they want the person to “get over it” because they no longer want to be faced with this uncomfortable subject.  I found a great quote by Lily Pincus, the author of Death and the Family: the importance of mourning and I agree with what she said. Pincus wrote, “Thinking and talking about death need not be morbid; they may be quite the opposite. Ignorance and fear of death overshadow life, while knowing and accepting death erases this shadow.” 

My experience has been that without the fear and attempts to ignore death I have an ease about life that I never had before.  It is not that I value life less, or value death more, it is that I see both as part of the same human experience and that acceptance has given me a peace that I never had before. Accepting death and life as equal has not stopped my feelings of loss and grief.  I think that is natural also.  I am left to live my life without the people who filled my days with love.

It is especially difficult without my son because I not only grieve for what I am missing without him in my life but also for the life that he was denied. Pincus also wrote about regression in grief and how it should not be seen as a negative sign but as a sign of healthy growth and adaptation. I think that is true too.  Grieving is not a linear experience.  There are starts and stops, stumbles and bumps, re-tracing of steps, plodding forwarding, becoming engulfed by the waves of grief, and then getting up and moving on again.  It doesn’t end at a prescribed time; it isn’t neat and tidy like many people would like it to be. It is a part of my life now and it's okay.

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.

Filling the Void--Grief and Addictive Behaviors

 

Sometimes grieving people will turn to unhealthy alternatives to fill the emptiness in their lives.  In my case, after the death of my son I filled the void by over-eating.  I already had a problem with weight and used food emotionally.  The loss of my son sent me into an eating frenzy trying to fill the hole in my heart by filling my stomach.  I ended up gaining 60 pounds!  It’s odd because in the initial weeks of grief I could hardly eat or drink and would have to force myself to get anything swallowed.  It was as if doing anything to provide fuel was counter to what my body was experiencing with the physical symptoms of grief.  That didn’t last and then I began the eating to excess.

Grief experts caution that grieving people may turn to addictive activities or substances in an attempt to cope with the loss.  Grieving individuals may increase their use of alcohol, abuse prescription medication, or begin using illegal substances as a way to self-medicate.  Unfortunately this usually results in further problems because the grieving person is already not functioning fully and these additional issues make life even more chaotic and sometimes dangerous.

Alcohol use is so prevalent in our society and because it is easily available, well-meaning friends or family may offer it to a grieving person to “calm their nerves”.  The problem is that alcohol is a depressant and if you are already in the throes of sadness due to grief this is going to make the problem worse.  In addition the physical toll from alcohol abuse will combine with the stress effects from the grief to make you even more exhausted and unable to cope with daily tasks. 

A message from the Dean of Students at Purdue University put it very well; “resorting to drugs [or alcohol] of any kind only turns down the sound while the music keeps playing.”  The grief is still going to be there and in the end you still must do the work to travel your own healing journey.  Nothing can take away the pain and numbing yourself to it will only delay the inevitable.  Many recovering addicts tell of beginning their addictions after a significant loss.  Once they become sober, even if it is a decade later, they still must experience the grief and go through a painful, delayed grieving process.

My use of food was my own negative coping behavior to try to shelter myself from the pain.  It didn’t work.  In addition to that I caused myself further health problems with increased blood pressure and high cholesterol.  The stress that my body was already experiencing was doubled because of my attempt to soothe myself rather than use healthier methods to grieve.  I have lost the weight and no longer look at food as “medicine”.

In my next post I will discuss some suggestions for healthy ways to help with healing on your grieving journey.

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.

Grief and Mindfulness--Part One

I was able to use mindfulness techniques in order to help me through with my grief.   I am so grateful that I was exposed to these easy to use techniques early in my grief journey.  What I learned about mindfulness meditation helped in those early months and continues to be something I use during times of stress and difficulty.  In this first part I will introduce you to one of the pioneers of mindfulness and medicine in the United States and then I will begin to explain why mindfulness can help the grieving person.  In the second part, I will explain some of the techniques that can easily be employed and used wherever you are.  I have added links to the author’s books for those who want to learn more about the subject.

Jon Kabat-Zinn, Ph.D. is the founder of the Mindfulness in Medicine, Health Care, and Society Center at the University of Massachusetts School of Medicine.  He has written numerous books on the subject of mindfulness.  One of the books that he wrote with a group of co-authors is called “TheMindful Way Through Depression” and has been highly successful and well received.

Kabat-Zinn is a scientist, with a degree in molecular biology from M.I.T. so he is not someone who is what you would consider a “New Ager” or into pseudoscience.  This guy has a brain and has studied the impact of mindfulness on the brain and the immune system.  He is considered one of the top experts on the subject.

Kabat-Zinn has been practicing mindfulness meditation since the mid-sixties.  In the late 70’s he started the Stress Reduction Clinic.  He reason for beginning this clinic was to bring Buddhist meditation into mainstream medicine sans the Buddhism.  Kabat-Zinn explains mindfulness as an act of self-compassion by paying attention to yourself in the moment.  Kabat-Zinn stated that he considers healing as “coming to terms with things as they are.” 

http://www.publicdomainpictures.net/view-image.php?image=12571&picture=meditation-by-the-lake&large=1

One of the few books that I found that combines mindfulness and grieving is “Grieving Mindfully” by Sameet Kumar, Ph.D.  Dr. Kumar is a Buddhist and a psychologist who works a cancer center in Miami, Florida.  Unlike Kabat-Zinn who takes the Buddhism out of mindfulness meditation, Kumar as a Buddhist comes from the Buddhist origin but he also states that as a psychologist he believes that the ideas of mindfulness can be successfully translated into the psychotherapeutic world.

Unlike some grief therapy methods that suggest that the grieving individual try to do everything they can to not think about the pain and sorrow they are feeling and to re-direct their energy, mindfulness asks that the griever tune into the pain of what Kumar calls the “intense pain of love after loss.”  Instead of denying the grief, mindfulness requires you to come to full awareness of the grief in order to really feel and experience the pain in order to soften the pain by living only in the moment.  Mindfulness allows the griever to mourn and experience the grief and learn from it in order to grow and be able to move away from the misery and make meaning of the pain.

Kumar notes that grief can be more difficult when we try to numb ourselves of the feeling and try to rush the grieving journey.  He states that often people around the griever will encourage the individual to move forward, get over it.  Kumar says that gives the griever the message that they are doing something wrong.  Kumar says that when we look at grief as an extension of our love than we can understand that there is nothing wrong with grieving.

Next--Part Two- Easy Mindfulness Techniques for the Grieving Heart

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