Category Archives: Grief and Loss

7 Ways to Cope With Grief From the Loss of a Pet

We encounter loss in all sorts of ways…the death of a loved one, the end of a friendship, the loss of a job….  One that we often experience is the loss of a pet, either  through death or the end of a relationship–and the grief that comes from this.  This special, and often unrecognized loss, is not easy.  So, how do we cope?

Our Culture’s Ideas About Pet Loss–Disenfranchised Grief

When a person dies, we usually know what to do.  We plan/attend some kind of service.  Perhaps we bring food to the grieving family.  Often, we send a sympathy card or donation to the requested charity.  However, there are types of losses when there aren’t clear-cut norms on how to behave.  Pet loss fits into this type of loss.    We are grieving, but others don’t understand why we are feeling so bad.  This is disenfranchised grief.

After telling a friend or co-worker that your pet is no longer in your life, you may receive the following remarks:

  • “Why are you still upset?  It’s only a dog/cat/bird/snake, ferret….”
  • “Why don’t you go and get another one?”
  • “He/she was really old/sick, so you had no choice but to ‘put him down.'”

The problem with these types of comments is that they don’t recognize the essential loss of our loved one, and the grief that you are feeling.  While people don’t often know what to say after a human dies (often due to lack of knowledge and discomfort); I can’t imagine telling someone to get a new partner right after the death of the love of your life!

Why We Grieve the Loss of our Pets

We grieve the objects, relationships and living things that mean something to us.  Our pets fit into a special category.  They provide unconditional love and companionship.  For some of us they fill the role of children or best friend.  We fit our lives and routines around theirs.  When they are gone, that means a lot of change.

It can become even more complicated when the loss occurs because of the end of relationship.  Our ex-partner has ‘custody’ of our pet.  We’re grieving not only the loss of our pet, but also the loss of the  human relationship.  It’s one thing to recognize that our animal family member is no longer on this earth, but to know that he/she is alive and inaccessible to us is another.

Grief is Grief…No Matter What We Have Lost

While everyone has different ways of grieving, J. William Worden in his book Grief Counseling and Grief Therapy, suggests that the following four tasks are part of the grieving process.

  1. Accept the reality of the loss.
  2. Process the pain of grief.
  3. Adjust to the world without what we have lost.
  4. Maintain a connection with what we’ve lost, while at the same time starting a new life.

These tasks apply whatever loss we have suffered, and in in working through them we find ways to cope.

7 Things You Can Do When You Lose a Pet
  1. Take the time you need to recognize what has happened.  You have suffered a loss, and that can be an emotional shock.  Even if your pet’s loss was anticipated, the reality is the same.  Taking time may mean booking some quiet time for yourself away from work or outside activities.
  2. If possible, think about what you want to do with your pet’s belongings before your pet’s death happens.  A big grief trigger can be coming home to see your pet’s leash or bowl.  Maybe your pet’s possessions can stay with a friend until you are able to decide what to do with them.
  3. Recognize that there may be big emotions.  Sadness, anger, guilt, loneliness can be part of the grief process.  What you are experiencing is normal.  One way to cope with them is to let them flow through you–they will pass.  If you find that the emotions are overwhelming, physical activity (such as going for a walk or run) can help.
  4. Talk to friends or family members who understand what you are going through.  Other’s who have lost a beloved pet tend to get it, and may be willing to walk with you on your journey.
  5. Increase your self-care.  When we are grieving we tend to stop taking care of ourselves.  Make sure that you are eating healthy food, and getting enough rest and exercise.
  6. Create new routines.  Our pets influence our routines as we plan our days around feeding times, walks and play time.  Think about how you can find ways to put new (and healthy) activities in those times in your day.  For example, go for a walk at the usual time, and change your route or ask a friend or family member to go with you.
  7. Find a way to honour your pet.  Some people create a ritual as a way to say goodbye.  Others keep their pet’s ashes or send the ashes to an artist so they can be included in a piece of artwork, glass or pottery.

In time, you will recover from the grief of losing your pet.  However, it may take time and the journey is an individual one.  If you find that you are getting stuck in this process, please reach out for support–either from friends, family or a therapist.

And now…since we’re talking about pets…what’s not to like about kittens and laser pointers?  Enjoy!

 

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The Caregiver’s Journey–Part 3

In Part One of this three-part series, we explored the specific parts of the Caregiver’s Journey–the beginning, middle and end stages–what can be expected at each stage and ways to cope.  Last week, in Part Two, we looked at caregiver burnout–the risk factors and warning signs.  Today, we’ll look at what happens when the caregiver journey is over.  This is the last in a three-part series on care-giving.

A Review of the Journey

If you have reached the end of the caregiver journey, you have gone through some difficult terrain.  You and your loved one have moved from an initial diagnosis and all the thoughts and emotions that this entailed.  As their illness became more severe you have adjusted your lifestyle to take this into account.

You have learned to ride the ebbs and flows of medical, community and family/friend support.

Along the way you may have experienced burnout, loneliness and the possible adjustment of adding ‘caregiver’ to your identity of spouse, partner, child, sibling or friend.  You have navigated the decision of either keeping your loved one at home, moving them into a hospital or made other arrangements for their care.

Now, with the death of your loved-one, the caregiver journey is over and you are embarking on a new path–grief.

The Grief Journey

Grief is hard. It’s messy, unpredictable and exhausting.  Grief is never experienced the same way twice.  It’s one of the most difficult things you will ever do.  And…grief is an opportunity for growth, a chance to develop resilience and discover strengths that you didn’t know that you had.  While grief may feel like depression, it isn’t…it’s grief.

When working with a client who is on the grief journey, I’m often asked “How long does this last?”  “When will I be done?”.

Grief is as individual as those who are experiencing it.  We all grieve in different ways, and there is no set time frame.  Just like a hike down an unknown trail, we’re not completely sure how long it will take to reach the end or what we’ll encounter along the way.  One thing is certain…we’re not the same people starting the journey as we are when we finish.

The Tasks of Grief

While everyone has different ways of grieving, J. William Worden in his book Grief Counseling and Grief Therapy, suggests that the following four tasks are part of the grieving process.

  1. We need to accept the reality of our loss.  Whether the loss is a person, place or thing; we need to accept the fact that the loss has occurred, and what was lost, is not returning.
  2. We need to process the pain of grief. Sometimes people experience grief as physical pain or develop anxiety/panic attacks.
  3. We need to adjust to the world without our loved one. Externally, this may mean adjusting to living alone, or developing a new routine.  Internally:   developing a new sense of self…”Who am I know if I’m not ….?”  Spiritually:  looking for meaning in the loss and determining the nature of the world (Is it kind or harsh?).
  4. We need to maintain a connection with who we’ve lost, while at the same time starting a new life. How do we remember, when we’re moving on?

While these are the ‘standard’ tasks of grieving, is there something specific to the grief journey if we have been a caregiver?

A Caregiver’s Grief

We come to the grieving process in different ways.  Sometimes the person we are grieving  has died suddenly, sometimes unexpectedly and sometimes with anticipation.  As a caregiver, all three can apply, and usually we know that death is coming.

When much of our life has been taken up with taking care of someone, even if they have moved into a care facility, their loss can leave a large hole in our life.  Our schedule may have revolved around our person.  Perhaps we visit the care facility on a daily basis, spending many hours each time.  The other residents and staff have started to feel like family, and visiting has given us a sense of purpose.  With death, we have not only lost someone, but also the opportunity to see the new friends that we have made.  This may be why some caregivers become volunteers at the care facility once the initial upheaval of grief has subsided.

There may be some ambivalence around the loss of our loved one.  On one hand, we may feel relief that they are no longer suffering.  If we are experiencing exhaustion or burnout from our care-giving role, we may also feel relief .  On the other hand, guilt may be our companion because of our relief.  “How can I feel such relief because my loved one is no longer here?”  “I am being so selfish!”  “How can I miss them so much and still be happy that I have ‘my’ life back?”

Grief can be a roller coaster,  cycling through the ups and downs of various emotions.  It’s all normal.  According to Buddhist thought, you are not your emotions or your thoughts.  Just like a roller coaster, the key is to hang on and ride through the highs and lows…without judging yourself.   Easier said than done!

Ways to Cope

If you are a caregiver, grieving the loss of the loved one you cared for, here are some ways that may help you to cope.

  • Take time to rest and adjust.  Chances are that you have been spending more time with your person during their dying process.  This can be overwhelming and exhausting–especially if you are already tired from long-term care-giving.
  • If you find that you are having trouble with physical issues, consult your doctor for support.  Sometimes at the beginning of the grief journey you may have trouble sleeping, or have an increase in the severity of your own medical issues.  Your doctor may provide short-term medication or at least put your mind at ease about what you are experiencing.
  • It’s ok at this point to be ‘selfish’ and take care of yourself.  When we have been taking care of someone for any length of time, we often put their needs before our own.  Now is time for you.
  • Ask for help.  There may be tasks that need to be done…some can wait and others need to be done as soon as possible.  If you don’t feel that you are able to complete these on your own, see if friends or family members can help.  Consult with care providers, financial and legal supports or funeral home staff to determine what can wait, and how to proceed.
  • Speak to someone that you trust about your emotions.  If you are having trouble dealing with feelings of guilt, anger, sadness, etc. talk to a close friend or family member.  If you don’t feel comfortable with this, or feel that it is appropriate, you can speak to a therapist to help you to sort out these difficult feelings.

And now…a caregiver’s tale… Enjoy!

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Once We’re Gone…

Unless we are presented with an opportunity to think about our own death (a diagnosis, loss of a loved one, serious car accident), it isn’t something that most of us want to spend time doing.  If left to our own devices, we tend to imagine that we’ll live, if not forever, at least for a very long time.  However, once in a while, we are given a non-traumatic invitation to think about what will happen once we die.

A while ago I discovered Magareta Magnusson’s book The Gentle Art of Swedish Death Cleaning:  How to Free Yourself and Your Family from a Lifetime of Clutter in my local bookstore.  Having been somewhat captivated by the Marie Kondo phenomenon that swept North America after the publication of her book The Life Changing Magic of Tidying Up, I wondered if Magnusson’s book was going to be more of the same.  However, I was sold enough on the title to make the purchase. What followed was a trip I hadn’t expected.

Down the Rabbit Hole

This is a deceptively simple book.  It can be read in an evening.  Rather than finding directions on the correct way to fold socks and organize my closet, “Death Cleaning” took me down an existential rabbit hole.  It wasn’t only a matter of doing family members the favour of paring down my possessions so that they would not have to take on this task once I am gone–I’m somewhat of a minimalist, so the job should be fairly easy.  Instead, it forced me to look at the items that I have held on to from the perspective of those I have left behind.  Would they know the story of a cherished mug or why I kept a moth-eaten sweater?  What is the ‘value’ of my stuff?  Does it really matter?

As I pondered these questions, I was reminded of a scene from Margaret Laurence’s The Stone Angel.  Late in life, the main character, Hagar Shipley had her first manicure.  She was so astounded by the positive feelings she experienced during the treatment that, once her nails had grown, she kept the nail clippings in a match box as a reminder of being cared for.  After Hagar’s death, when her children find the box, they can’t understand why their mother would keep such a thing, and put it down to dementia.  Hmmm….

Not Everything Is the Same

Imagine that you are looking at your things through the perspective of your loved ones, after your death.  Some things we leave behind will spark feelings of humour (I can’t believe that Mom kept every card I ever sent!), confusion (a box of nail clippings?  Really?) or neutrality (the contents in the bathroom cupboard).  Unfortunately, some possessions are emotionally charged, and it is these items that require more thought and action.

A Story…

After their mother’s death, Sylvia and her older sibling Paul had the task of cleaning out the family home in preparation for sale.  Their father had died two years before.  As the siblings started working through the house, they were astounded by the amount of things that their parents had collected.  Neither parent had wanted to discard anything, and the house was a museum of their lives together and as a family.

Over time, many car loads of items were taken to charity shops. Family members and friends were invited to choose an item to remember the couple by.  A dumpster was placed in the driveway to get rid of decades of newspapers, magazines and assorted other ‘junk’.

On most weekends, the siblings worked together on this project.  It was going well…until…they found…THE BOX.  Hidden in the back of a closet was a box of journals written by their father.  They covered the years from being newly married until Paul’s birth.  Sylvia and Paul were excited to discover a record of their beloved father’s thoughts and feelings and looked forward to learning more about him–in his own words.  Unfortunately, as they read, their excitement turned to hurt and confusion as they realized that their father had never wanted to have children, but did so as a concession to their mother–whom he had loved deeply.

Suddenly their relationship with their father came under the microscope.  Did he change his mind?  Did he ever love them?  Was the time he spent with them only to please his wife?Since they already had one child, was Sylvia planned?  Because both parents were dead, all these questions were left unanswered.  The siblings could be trying to come to terms with this information for the rest of their lives.

When We’re Ready the Teacher Will Come

As I continued to look at my possessions from the perspective of not being able to explain them to those I leave behind, asking myself what (if anything) I should get rid of now in order to spare them any future pain or misunderstanding; I met Jill Sadler.

Jill is the owner and principal consultant of Parosol.  She describes her company as “estate planning redefined”.  Parosol’s promotion material explains:

“We work with you to document and create a complete care, legacy, health and aging plan that you can share with the important people in your life–making sure your wishes are known and you are in control of your future.”

I wasn’t looking for Jill. Yet she came across my path as I was asking myself difficult questions about how to make decisions easier for my family if I was no longer able to provide direction or explanations.  As I learned more about Jill and her company, I realized that she would be a valuable resource as I move along this path.

Your Mission, If You Choose to Accept It

While the story of Paul and Sylvia is fiction, unfortunately their experience isn’t uncommon.  I have worked with many clients who struggle with information learned after the death of a family member or with having to make decisions without knowing a loved one’s wishes.  And, as I learned from Jill, we don’t have to be dead to be unable to communicate what we want–an incapacitating illness will do it!

I encourage you, no matter your age or life situation, please take some time to look at your ‘personal’ belongings from the perspective of those you leave behind.  It may be a bigger bequest than anything you leave in your will.

And now…for those of you too young to recognize the last heading…some vintage Mission Impossible (before Tom Cruise)!  Enjoy!

 

 

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The Grief of Saying Goodbye…to our stuff

 

The recent Spring-like weather may have some of us thinking about Spring Cleaning!  If this is you, here is a post from the archives that may be helpful.  Enjoy! 

We often think of grief and loss as relating to life events such as the death of a loved one or being let go from a job…but what about, through financial difficulties, divorce or aging, we lose our stuff.

There’s help for the physical process.

I recently met with Susan Kemp of 4 Life’s Transitions (www.4lifes.ca).  Susan and her team help families and older adults deal with the issues and challenges of dissolving a lifetime of residential  accumulation.  A large part of Susan’s work is supporting individuals to sort through their belongings with the goal of moving their treasures on to new owners.

As we talked, it became clear that often the most difficult part of this process for people isn’t the physical moving of the items, but the act of letting go.  A table isn’t only a table; it’s the location of countless family dinners and the associated memories.  Even simple items such as a collection of sewing fabric is a reminder of when each piece was purchased, or was left over from making a child’s cherished prom dress.

There are ways to cope with the emotional process.

Some people have no problem saying goodbye to their things as they choose to move them on to others.  In fact, individuals practicing minimalism or simplicity report that the act of downsizing their possessions is emotionally freeing.  The important word here is “choose”.  How do we cope when we are forced to say goodbye to our treasurers or possessions by events beyond our control?

Recognize that the process is difficult.

The process of letting go is hard, so be gentle with yourself.  You know the healthy things that make you happy and help you relax, so make sure you have easy access to these things.  Have  trusted people ‘on call’ who are aware of what you’re doing and can offer support.

Be sure to take frequent breaks–nothing can lead to feelings of being overwhelmed than being tired or hungry.  I often encourage my clients to create a ‘self-care box’ that houses items that they can use to help with calming.  While the contents are individual, some people include a favourite movie, tea, bubble bath, journal, list of phone numbers of supportive friends/family members, etc.

Share the task with a friend or family member.  Joshua Fields Millburn and Ryan Nicodemus of “The Minimalists”  describe hosting ‘packing parties’, where they enlisted friends with task of boxing up Ryan’s possessions.  In this way, many people are there to help, and it was a party.

It’s not just about stuff—some items are emotionally loaded.

It’s easy to get blind-sided by the memories of our possessions as we sort through them.  Not only can this add a lot of time to the process, it can also leave us emotionally drained. Besides tapping into the self-care ideas/box mentioned above,  what are your other healthy coping strategies?

Have a ritual for saying goodbye.  Some people take pictures of their possessions before putting them in a box.  This way, they can visit their ‘things’ whenever they want.  Other people will write a farewell note to items that hold special memories.

Marie Kondo, author of The Life-Changing Magic of Tidying Up:  The Japanese Art of Decluttering and Organizing, encourages her readers to imagine the new life that their possessions will have when they meet their new owners.  When I chose to donate many of my children’s toys when I downsized my home, it helped to think about the children who would be able to enjoy them.  Especially since my adult children had outgrown the Fischer Price castle!

Control who receives your items.

I recognize that choosing who is to receive your possessions can be tricky.   In some families there is little argument about who is to take home Dad’s stamp collection or Grandma’s favourite china cup.  In others, disagreements about who takes possession of possessions can cause permanent cut-offs between family members.  If you think that your family may fall into the second camp, it’s a good idea to work with a therapist to help sort out the underlying feelings that are leading to these arguments.  Often, the fights are not about the family china, but deeper, undisclosed issues.

On a more positive note, when my grandmother decided to move into a senior’s home and pass on her possessions, she chose who was to receive each item and then spent many years visiting her ‘things’.  Nana reported feeling great joy at seeing how her belongings took on new lives in her grandchildren’s homes.

Tap into your values by supporting a charity.

Donating our items can be a wonderful way to say goodbye.  For some people it gives the process of letting go a sense of meaning.  If your favourite charity doesn’t accept physical items, selling your belongings and donating the money is an alternative.  Some agencies, such as the Mennonite Central Committee will even pick up large items such as furniture.

At the end of the day, it is only ‘stuff’.  As Grandpa Martin Vanderhoff says in the 1938 Academy award winning movie “You Can’t Take It With You”; “As near as I can see, the only thing you can take with you is the love of your friends”.

If you’re in the middle of packing up your stuff, here’s the link to the radio version of the movie.  Enjoy!

 

 

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Comings and Goings…The Circle of Life

People come and go in our lives for a variety of reasons.  Sometimes it’s because we meet a new friend, or a relationship ends.  Maybe we’re the one coming and going as we change jobs or move to a new city.  At some point, our entrances and exits are more substantial…we are born and we die.  That’s the circle of life.

In the Not So Distant Past

While both birth and death are an unavoidable part of the human experience, I suggest that as a modern culture, we treat each of them very differently.  However, this hasn’t always been the case.

As a big fan of Call the Midwife, I never tire of watching the sanitized TV version of babies being born. The series takes place in an East-London neighbourhood, during the 1950’s and early 1960’s.  Among other things, it chronicles the progression from the norm of home births to hospital births; and the resulting changes in the expectations of everyone involved.  I’m not advocating one birth experience over another, just noting the shift of birth taking place at home vs. taking place in a medical setting.

Like birth, death has also moved locations. In the past, the common practice was that we died at home–circumstances allowing. Ideally, the dying person was surrounded by family and/or friends who were there to offer comfort to the individual and each other.  Family members shared the final tasks of preparing their loved-one for burial. Visitation was held in the family home. Birth and death were very personal, yet community, experiences. Now, most of us can expect to die in a hospital, and prepared for our final resting place by funeral home staff.

A Semi-Current Picture

According to Statistics Canada, in 2014 approximately 259,000 Canadians died. The Fact Sheet published about Hospice and Palliative Care in Canada reported that 70% of those deaths occurred in hospitals.

On the flip side, 2014 saw approximately 384,000 Canadian births (142,000 in Ontario). A December 2015 Toronto Star article outlined a three-year McMaster University study that noted midwives attended 10% of all births in Ontario (2014 is included in their data).  Of this 10%, 20% of these births occurred at home.

The bottom line…most of us will come and go in a hospital.  However, the picture may be changing.

Thoughts on Current Practices of Life… 

Midwifery, was regulated in Ontario in 1994, as a publicly funded service. Currently there are more than 700 registered midwives in Ontario who provide neonatal care to pregnant women, attend their deliveries and look after the mother and baby following birth.  With the 1994 law, midwives have hospital privileges (including access to hospital staff and resources). The blending of the two options gives expectant parents more choice of where to deliver their babies.  It is no longer a binary decision of at home with a midwife vs in hospital with a obstetrician (most family doctors no longer deliver babies).

According to the McMaster study, for women with low-risk pregnancies, babies delivered at home were at no greater risk than those in hospitals. We can have the best of both worlds.

…and Death

The same choice has begun around end of life decisions as well. The number of hospice centers and palliative care support is growing steadily.  According to an Ontario Ministry of Health and Long-term Care position paper:

“Ontario is working to provide patients with more choices for palliative and end-of-life care.

This includes investing in more hospice care across the province and expanding caregiver supports that help families and loved ones support palliative patients at home and in their communities. Ontario will also support more public education about advanced care planning so that patients’ wishes for end-of-life care are understood. The province is establishing clear oversight and accountability for Ontario’s palliative care services, to further advance patient-centred care.”

It will be interesting to see the effects of assisted death legislation on end-of-life location options.

Speaking of options, there are now death doula’s or midwives who spiritually help individuals and their families through the death process.  Training programs to become a death doula are now available throughout Canada and the US.  Both MacLeans magazine and Global News have covered this subject.

Death is Making an Appearance

While our culture tends to hide death–even in the language we use to describe death (“passed away” or “passed on”);  I have started to notice some changes.  Besides the increased visibility of hospice and palliative care and debates on assisted death, end-of-life has started to take up space in our current frame of reference.

At first it was something I glimpsed out of the corner of my eye.  A colleague had mentioned that he had attended a weekend workshop on “home funerals”.  The event took place in a private home, and included information about the rules and some basic skills for taking care of your deceased loved from death until burial. While not for everyone, this is a fascinating alternative to the current practice.

Next, over the six-month period, numerous articles appeared in the local paper:

  • A story about a Romanian cemetery (called the Merry Cemetery) where the crosses are etched with colourful epitaphs and drawings describing the deceased’s life and/or personality;
  • A helpful article about “tying up the loose ends of life”;
  • Another article assuring readers that “death doesn’t have be so frightening”;
  • A commentary of the Mexican tradition of the Day of the Dead–a family celebration that sees family members and friends having parties in local cemeteries as they visit their loved ones;
  • And finally, a review of the book  “The Gentle Art of Swedish Death Cleaning: How to free yourself and your family from a lifetime of clutter.”  A new reason to declutter.

I came across information about the Good Green Death Forum (an event organized by the Green Burial Society of Canada) and DeathCafe.com (a social event where people talk about death with the goal of increasing their awareness of life).

Ideas about death appear to be popping up in popular culture.

Why Does This Matter?

As a therapist, I tend to look at things through the lens of mental health.  While birth is usually a happy event (no matter where it takes place), I have concerns about how we deal with the end of life. With the movement of death from plain sight over the past decades, it has become scary.  Combined with our culture’s fixation on youth, this fear has escalated.  As with most things in life that we don’t understand, when we push them away they become something mysterious, and to be feared.

But do we have to continue to treat death this way?  Instead can we use a familiarity with death as a tool to help us live more aware and fulfilling lives?

Another Way to Look at Death

In many Buddhist traditions, a purposeful contemplation of death is one practice that is used to help individuals become aware of the constancy of change and life’s fragility.  The concept is that when we realize that nothing in life is permanent and everything is easily broken, we look at events in our lives differently.  We may appreciate to a greater level not only what we have (including health, relationships, and things), but also the people we love.  From this perspective, while we may grief loss (from the breaking of a favourite cup to the loss of something greater), we understand it to be part of a greater whole.  As well, to quote a best-selling book title, we “Don’t sweat the small stuff…and it’s all small stuff”.

Death as an Exercise

I’ve come across a few books over the years (The 7 Habits of Highly Successful People and She Means Business (to name a few) that advise readers to become comfortable with their own death as a way to add focus to their lives.

These authors lead a guided exercise in which the reader imagines, in detail, their own funeral or memorial service–paying particular attention to what their family and friends are saying about them.  These imaginary statements become nuggets to be mined as you set life goals.  I’m not sure if it works, but could be an interesting exercise.

Finally…

We can’t hide from the comings and goings in our lives…whether it’s us or someone else.  However, we can become less fearful and more mindful.

And now…somewhat predictably, but none the less still moving after all these years (movie came out in 1994)…The Lion King – Circle of Life.  Enjoy!

 

 

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Grief is a Genesis, Not a Finale

Often the greatest wisdom comes from someone who is, or has lived through, a certain experience. When I discovered this “Point of View” article  entitled “Grief is a Genesis, Not a Finale” in the May/June 2017 issue of Psychology Today, I knew that I wanted to share it on this site.  Below is Ms. Sabbage’s article in its entirety. 
 
The author, Sophie Sabbage, continues her journey, and is the author of the book and PT blog The Cancer Whisperer.
Before I was diagnosed with incurable cancer at the age of 48, I had passed grief by like a stranger on the street. I had reserved it for death and heartbreak, the shattering losses that bend us double—but not for the regrets, disappointments, and failures that also ask us to grieve. I thought it brought closure, but now I know that grief gives life.

The news of my condition unfolded over a six-week period, one tumor at a time. First my lungs; then the lymph nodes in my throat and chest; then my bones—ribs, shoulders, spine. And finally, multiple lesions in my brain. My options seemed extremely limited, but I soon heard about a pioneering oncologist in Mexico who was reversing late-stage cancer and didn’t turn patients down. After emailing him my scan results we clung to this whisper of possibility, waiting for it to mature into certainty.

The call didn’t come for two weeks. My husband, John, took it while I was putting our 4-year-old daughter, Gabriella, to bed. I could hear the sound of his voice downstairs, but the words were muffled so I focused on her bedtime story and helping her fall asleep. This involved lying next to her while she snuggled into my armpit and kneed me in the ribs a dozen times before her perpetually moving legs finally gave up the ghost. When she looked up at me and said, “Mummy, my legs won’t let me sleep,” I wondered where they would carry her in the future and if I would be there to see it. I wondered. I yearned. I prayed.

John said walking up the stairs that evening was the steepest climb of his life. He had to tell me that the oncologist who doesn’t turn patients down had turned me down; that I was that far gone.

Grief didn’t burst its banks when he told me. There was no wailing or gnashing of teeth. Instead it visited us like a living entity and enfolded my whole family in its blanket. John was desolate. It had taken us so many years to find each other and he loves me so much. But his pain distracted me from mine. I could attend to it instead of cratering inside. I could kiss the top of Gabriella’s head, pull my husband onto the bed with us and take what this moment had to offer: the great love we had found, the scale of which could only be matched by the sorrow we felt at the prospect of leaving each other after too short an embrace on Earth; and our high-voltage daughter, who wears her father’s smile as she explodes toward tomorrow and whose legs have a life of their own.

Grief became my guest and an almost constant companion. I was letting go of what I had achieved in life (like conceiving Gabriella after being told I couldn’t have children) while lamenting what I hadn’t achieved and wouldn’t: buying a forever home for my family when I could finally afford it; withering with my husband into beneficent old age while our daughter rises into her purpose like a blood-red sun on a black-and-silver sea; writing books. Each day brought another letting go. The vision in my left eye faded. I forgot how to spell simple words and sometimes forgot the words themselves. I closed the consulting business I had spent 20 years building. I stopped driving my car. The large tumor on my vertebra, at the midpoint of my neck, pressed against my spinal column and truncated my countryside walks until I could only putter around the garden. And the day came when I couldn’t pick up my daughter from a standing position—which was almost more than I could bear.

With each loss I turned toward grief instead of away from it, and began to discover its true nature. This was partly prompted by discovering that, according to Chinese medicine, grief is held in the lungs. Since I had lung cancer, this begged the question, “What have I not been grieving and why?” I was convinced that cancer is as much an emotional and psychological disease as it is a physical one, so this line of inquiry seemed as essential to my healing as the medical treatments that slowly began to turn things around. My cancer needed me to grieve and I needed cancer to discover my grief.

(Photo courtesy of Sophie Sabbage)

The biggest breakthrough came when I visited a small herd of horses in a field just a few minutes’ walk from my house. I had grown up with horses in the lush green valleys of South Wales, where galloping into the wind over the vaulted hills was the best way I knew how to silence the incessant inner self-criticism that marked my teenage years. I continued riding as an adult, usually on vacation, and it had remained one of my greatest joys in life. That day, just a few weeks after the Mexican doctor turned me down, the horses walked up and encircled me, like the standing stones of Stonehenge. Initially, I was delighted, but as I stroked their soft necks I realized I would never ride again because my tumor-clad spine couldn’t tolerate any jarring. And thus, in a wet field on a cold winter day, my heart broke like a levee with grief.

Far from dragging me down, however, grief raised me up. As it rolled through my cells I felt lighter, freer and literally more able to breathe. My body continued to break down for a while, but my heart’s locked-in hurts began to heal. I was able to forgive those I hadn’t forgiven, from the girl who bullied me in the playground as an 8-year-old to the various sexual assaults I had discounted because I didn’t want to make a fuss. Perhaps more important, I was able to forgive myself. I knew the part I had played in my disease, the ways I had mistreated my body through my youth, the relentless bending my life into an apology for my blessings as well as my flaws. Physically, I could barely turn my head from side to side, but emotionally I was beginning to lift it without shame.

There is a “break” in the word breakthrough—something must break for something new to grow. This is what grief does. It broke my denial, restoring me to the stark naked reality of what I was facing and thus to the natural order of things. It offered a bridge from the life I had planned to the life I was actually living. Where fear closed my heart, grief opened it. It drew back the curtain on what I have loved and do love. Because its purpose is to keep love alive.

When some of the long-standing friends I had assumed would show up with vegetable casseroles retreated from my imminent demise in awkward silence, I felt hurt and angry. Among these was my best friend for nearly 20 years. We had fallen out nine months before my diagnosis over some differences that had been brewing for some time, but I felt confident that we would resolve them. We had been business partners as well as friends and often taught conflict resolution to our clients. We needed time to lick our mutually inflicted wounds, but we also knew how to heal them. It was what we did.

On hearing I had cancer she emailed me to “find solace in one another again,” but I was wary. I was extremely vulnerable at that time and death was stalking me like a permanent shadow. My condition didn’t heal the hurt or diminish the depth of our differences. Nor did I want cancer to become a get-out-of-jail-free clause for the things we both needed to apologize for and forgive. Instead, it called for a deep dialogue and heartfelt reconciliation—or so I thought.

She wasn’t up for it. I asked for a meeting to talk through what had happened between us instead of brushing it under the carpet. I said things that were better saved for face-to-face, or  not said at all. I was raw as sushi at the time and regret how I handled it, but I don’t regret refusing to gloss over undercurrents of animosity when I most needed to feel safe. She requested that there be “no further communication between us.” And that was that.

At the time I didn’t know that this decision would free me to move into a completely new sphere of friendship, vocation, and service—or that gratitude would supersede the pain. I have not forgotten who she was to me and still miss her acutely some days. But I remember her with love, not rancor, because I gave our friendship to the river of grief that has merged with my bloodstream and now flows like oxygen through my beckoning life.

Grief released friends who backed away as gratefully as it received the friends I had long since alienated or lost touch with. They reappeared with gentle eyes and ready hands as if the years between were merely parentheses in an unfinished sentence. All of it liberated me to love more honestly. And thanks to grief, the authentic intimacies of my life prevailed.

Within three months of medical treatments and emotional healing my life force returned along with my vision and ability to spell. I can pick up my now 6-year-old daughter. I even galloped a dappled grey horse along a Moroccan beach. I wrote a book. I am still living with the death sentence I was given over two years ago, but it keeps the channels of grief open, which rise and fall like a tide, but always deliver me back to the shores of what I cherish most. My greatest wish is for cancer to leave me so I can raise my darling girl until she is self-assured enough to run headlong into her destiny. But I hope grief remains. My love is less without it. Not entirely itself.

Grief is the most unlikely gift cancer has conferred on me. It walked me through the fog of my despair into a vast landscape where I could see the heavens overhead and feel the mercies underfoot. Grief freed my spirit before it left my body and, in a very real sense, it raised me from the dead.

 

 

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Grief: What’s the Rush?

I read a lot.  I read to increase my knowledge to be useful to my clients.  I read in order to figure out how to do things, and I read for pleasure. Despite the number of books and articles that I read, it’s not often that I experience a “really?!” moment.  However, that’s what happened when I recently read Closure:  The Rush to End Grief and What It Costs Us by Nancy Berns.

As the title suggests, the premise of Closure is that, in Western culture we are encouraged not only to hurry through the grief process, but that there is an acceptable way to do so. The “acceptable way” can be summed up in the idea of “closure”.

What is Closure?

What comes to mind when you think of “closure”?  Chances are that your ideas may be different if you are a mathematician, business person or jeweler.  From a psychological perspective, the Cambridge English Dictionary defines closure as “the feeling or act of bringing an unpleasant situation, time or experience to an end, so that you are able to start new activities”.  This definition suggests a distinct point in time–the point between the past and future.

However, is closure that cut and dried?  How do we know when we’ve attained it?  Do we even want it?

A Story

For Emily (teacher) and Darren (general manager at a golf course), this particular Tuesday started out as usual.  They woke up with the alarm clock at 7 a.m.  He walked the dog while she showered.  Emily made breakfast while Darren got dressed.  They quickly ate together, sharing their plans for the day before heading off to work.  Suddenly, at 11:15 a.m., things went terribly wrong.

Darren was meeting with the catering manager when he received a call from Emily’s principal.  Emily had passed out while supervising the morning nutrition break and had been rushed by ambulance to the local hospital.

By the time Darren arrived at the emergency department 15 minutes later , Emily had died. The autopsy showed that Emily had succumbed to a massive heart attack.  She was 34 years old.

The following days were a blur for Darren.  Family members arrived to help with decisions. The meeting at the funeral home revolved around choices that would help Darren, and others,  to say goodbye to Emily and reach a place of closure.  Not sure what to do, Darren followed everyone’s advice to have a traditional funeral and reception.  At the reception, many people commented that Emily would have been pleased with the service and how that must help him to find closure.

After a month, Darren returned to work.  He was still dazed, and decided that a regular routine would be helpful.  When colleagues noticed that he ‘still’ wasn’t himself, he received suggestions on how he could move ahead in his grief in order to find closure. Friends also added their opinions about his behaviour with comments about how to move on.  They told him stories of how others in his situation had been able to find closure after the death of a loved one.

Angry, hurt and frustrated by others’ input, Darren decided to deal with his grief privately–no longer telling people the truth of how he was feeling.  If closure meant that he would leave Emily behind, and if that’s what was expected of him, he had no interest.

 Closure Language and Grief

Berns states that the addition of “closure” language has become a common part of grief culture, along with the idea that we haven’t successfully completed our grief journey until we have reached a place of closure and are able to move on.  However, many people, like Darren, feel that the idea of closure isn’t possible as the pain of grief never goes away. The pain decreases, but it never disappears.  In fact, some people adamantly resist the idea of closure as they don’t want to say goodbye forever.

To make matters worse, closure language can put pressure on people who are already feeling unsteady as they try to cope with a ‘new normal’.  If they aren’t experiencing closure or have decided that they don’t want closure (as defined by cultural norms), they may fell that they are not “doing it right” and feel shame on top of all the other emotions that they are dealing with.  These people often say that they have found closure as a way to be acceptable in the eyes of others–even if they haven’t.  This rushing and faking may prevent them from performing the tasks of grieving.

The Tasks of Grieving

While there isn’t a universal map for the grief process, there are recognized tasks for the journey.  J. William Worden in his book Grief Counseling and Grief Therapy, suggests that the following four tasks are part of the grieving process.

  • Accept the reality of the loss.  Whether the loss is a person, place or thing; we need to accept the fact that the loss has occurred, and what was lost, is not returning.
  • Process the pain of grief. Sometimes people experience grief as physical pain or develop anxiety/panic attacks.
  • Adjust to the world without what we have lost. Externally, this may mean adjusting to living alone, or developing a new routine.  Internally:   developing a new sense of self…”Who am I know if I’m not ….?”  Spiritually:  looking for meaning in the loss and determining the nature of the world (Is it kind or harsh?).
  • Maintain a connection with what we’ve lost, while at the same time starting a new life. How do we integrate the person into our life?

The goal of these tasks is to adjust to a new reality and integrate the missing person, place or thing into that reality.  We are not leaving anything behind,  unless we choose to.

Closure and Grief as a Commodity

Now for an explanation of my “really?!” experience.  I feel that grief is a normal and natural response to a life-changing event.  It is a process that takes as long as it takes–an individual journey, with individual results.  When we are told what that process should look like and what the end goal should be (i.e. closure), I have a problem.

Closure:  The Rush to End Grief and What It Costs Us provides many examples of how closure has become a commodity.  Berns describes how closure language has been used to sell everything from public memorials, capital punishment (Berns is writing in the US), as well as extravagant funeral and burial services for both people and pets.

The author goes on to show examples of elaborate (and sometimes grotesque) divorce parties that include everything from a pinata featuring a picture of your ex-partner’s face, to small caskets for wedding ring burials and divorce cakes with headless grooms or brides.  The goal is a sense of fun and closure.  Really!?

As a therapist, I question the value of the grief process being treated as a sales opportunity to the person living with loss.  As Darren experienced, the funeral home was “selling” closure.   Depending where Emily died, an autopsy may not have been required, but could have been offered as a way to provide closure for Darren and his family.  If Darren had decided against a traditional funeral, he may have been approached by a business offering to turn Emily’s ashes into jewelry or sew them into custom-made stuffed toys that can be distributed to loved ones.

Some companies specialize in scattering ashes either by boat or plane–their message being that we find closure in this act, and that we better not attempt it ourselves. There are successful and unsuccessful ways to spread ashes, and it’s important to leave it to the ‘professionals’.

How Can We Avoid the Commodification of Grief?

When we are in the throes of loss, we can be at our most vulnerable to the opinions of others.  We may begin to doubt ourselves, as well as our ability to know what’s best for ourselves and loved ones.  How can we avoid being sold things that we don’t want in search of “closure”?

  • Have important conversations with our loved ones about our final wishes.  When everyone is aware of our expectations, there is less of a chance that they will feel pressured to buy things in order to “give us a good send-off” and find closure.
  • When loss happens, whether through death, divorce, job loss, etc.; surround yourself with trusted people–those who have proved themselves to be trustful before the event.
  • Recognize that the grief journey is an individual one.  Trust yourself that you know what you need and have the strength to ask for/provide it.
  • Be aware of the prevalence of “closure language” in our culture.  You can choose if you want to include it in your grief journey (or not).

And now for one of the most touching scenes from Forrest Gump…bring your Kleenex!

 

 

 

 

 

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