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Is “Masculine Grief” a Thing?: Day 25 of #31DaysWithGrief

Posted by Carla Cheatham on

January 25, 2017

31 Days of Walking with Grief: Others’ and Our Own

Day 25—Is “Masculine Grief” a Thing?

This is a month-long series to support persons grieving and those who love them. It includes content from “Sharing Our Stories: A Hospice Whispers Grief Support Workbook” available through Amazon and wherever books are sold.

Stigmas around death and grief…

With our technological advances, we’ve come to be pretty disconnected with death in the last century. Compared to our previous lives on farms and ranches, when we spent more time in nature with the ebb and flow of fields, livestock, and even the elderly members of the family who lived with us, we rarely touch it, now. We’ve come to see death as a failure to be prevented rather than a natural and expected part of daily living.

Our stigma around death extends to our discomfort with grief. Studies show we have a very set, prescribed view of what is and is not acceptable, even attractive, in our grief responses (Kubitz, Thornton, and Robertson, 1989). We have a very narrow window of tolerance for the ways in which those mourning are allowed to express or cope with their grief before they face our judgment.

Women who openly emote immediately following a death are seen with compassion, understanding, and support, so long as their response isn’t considered “too much”. As time passes, if women continue to openly show their grief through tears, they’re judged, “Isn’t she over it, yet?”

Men face even more…

Men, on the other hand, are in even more of a bind. If they show no emotion right after a death, they can be judged as cold and disconnected but, if they show emotion, we write them off as weak and overly sensitive. If they show grief after time has passed? Forget about it. We can’t handle that, and it’s not just men who judge other men; they face it from the women in their lives, as well.

This very insightful piece from Mark Mercer points out some of the differences in the ways that men may grieve that are often misunderstood and not recognized for what it is.

We may think that men are not grieving, but it’s because we tend to think of the stereotypically feminine style of grief as being the only way.

In my family, I watched the men work for 2 days to design and build a wheelchair ramp that would withstand a tornado, even though it was pretty clear our loved-one’s decline was so rapid he would never actually be able to use it.

Working side-by-side in silence, they sweated and pounded and solved a practical problem for the man whom they loved who could no longer carry 4x4s and cement for himself. It was what they had to give and how they processed the circumstance. But I also know they later cried in private.

Being physically engaged, working out the energy of powerful emotions through movement and physical labor, taking time alone and in silence to solve problems and consider practical matters are some of the ways many men may be more likely to grieve.

Research is still teasing out whether that has to do more with genetics, the way we’ve taught men to grieve, and/or whether those are the only options we allow them to engage in. In reading the Mercer piece above and remembering my own family’s story, I have to wonder, if our society could allow it, if more men would more easily demonstrate an emotive style of coping.

A healthier view for us all…

Researchers once joined in with this dualistic view of masculine vs. feminine grief—men work logically and in silence while women cry, talk, and seek support. Now, we realize that these two styles are opposite extremes of a continuum with variations everywhere in between that both men and women can effectively use to cope based on their cognitive styles, culture, responsibilities, nature of the relationship with the deceased, etc.

These two styles are more commonly being called Instrumental (the more stereotypically masculine means of coping) and Intuitive (what we generally label feminine grief). An excellent interview with grief expert, Ken Doka, contains even more information about these styles.

We now know that whatever works for a person in coping with their grief is what we must support and that we do everyone a huge disservice when we pigeon-hole men and women into one particular style. The Instrumental and Intuitive terms promoted by Doka and others is a good place to start with getting over our narrow thinking and stigmatizing views.

Some research even demonstrates that if men and women are feeling stuck in acute grief later in their grieving process, problem solving (Instrumental) interventions are most successful with women and affect-stimulating (Intuitive) interventions are more helpful for men. It’s as if their preferred (or assigned!) style didn’t work for them in the first year, and they needed another coping style to help them come further through their grief.

Regardless, there are three points to make here:

We must not miss that men are grieving just because it doesn’t look like the stereotypically feminine/emotive style of grief.
We must not pigeon-hole men into only one coping style, but allow them the full range of options on that spectrum between Instrumental and Intuitive styles mentioned above.
Women can clearly find some relief from exercising the styles more often attributed to men, and should feel free to explore those ways of coping, as well.

Taking off the labels that can confine us, opening our eyes to see grief in all its many forms, and allowing everyone to access whatever tools work best for them in their circumstances is one of the important tasks ahead of us as we mature in our understanding of bereavement.

Perhaps Randall Horton said it best at the end of his beautiful piece in the Huffington Post,

“I dream of a world where grief is not gendered and where masculinity is not marked by solitary sorrow.”

And so may it be, for the sake of us all.

Peace,

Carla

Rev. Carla Cheatham, MA, MDiv, PhD, TRT has served hospices as a chaplain and bereavement coordinator. She’s the Section Leader for the Spiritual Caregivers Section of the National Hospice and Palliative Care Organization and an adjunct professor at the Seminary of the Southwest. Through her Carla Cheatham Consulting Group, Carla provides training and consulting for professional caregivers nationwide. She is the author of Hospice Whispers: Stories of Life and its companion volume, Sharing Our Stories: A Hospice Whispers Grief Support Workbook. Her next book, On Showing Up with Suffering: Others’ and Our Own, is set to publish in 2017.

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Sibling Grief: Day 24 of #31DaysWithGrief

Posted by Carla Cheatham on

January 24, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 24—Sibling Grief

A friend said to me last year, “When you write your next book, PLEASE include what it’s like for us siblings. We always get left out!” So many dynamics come up around the death of a child that it can be impossible to address them all. The experience of the other children in the family often gets missed.

What it can be like…

Some siblings are close and loving. Others argue and fight. Most are a mixture of the two. If the child was a confidant or companion, that loss could be deeply felt. Losing a roommate or having your own bathroom may seem like a dream, until it comes by way of death and you’re sleeping alone in a way too quiet room. If the children weren’t close, guilt, which is already common for children to feel about a death of someone around them, may arise.

Regardless of how close they were, the sibling’s whole life has been thrown into turmoil. Parents and grandparents are distraught and often distracted, the comfort of routines and visiting with friends can disappear, new grownups are in and out of the home at all hours and the phone rings off the hook, things are happening that they just can’t understand.

Perhaps the child who died had an illness that already took time and attention away from the sibling and they resented it, or even felt relief that the turmoil around the illness and trips to the hospital and constant disruption were finally over. Either of these can prompt guilt in a sibling.

As life tries to move forward into a new normal, the child is having to adapt, as well. Sometimes, children adapt quite well. They grieve as much as they are able to in the moment and then can continue to grieve over the years as they cognitively develop and can handle more.

It can also be very hard for them to feel invisible while everyone around them grieves, and supports the parents’ grief while forgetting about the needs of the children. Siblings can feel pressure to grow up faster than usual to be more self-sufficient, emotionally and physically. They may try to make their parents feel better, and struggle when they can’t.

The vacuum left behind…

They may even try to make up for the vacuum left by their brother or sister, working to fill their shoes or fill the role they played in the family dynamic. Some parents may inadvertently put pressure on the child to do so. Feeling the incapable of being like their sibling, or even the pressure to try, can lead the child to feel incompetent, inferior, and never good enough.

One man, whose older brother died when the man was 6 years old, struggled for years with the magical thinking children can engage in to try to cope that told him if he was just good and loving and easy enough as a child, his mother would be happy again. Of course, that wasn’t rational. Of course, he couldn’t make that happen. And of course, his young mind felt responsible, and that small part remained with him for decades, until he finally dealt with it.

Siblings have has also come face to face with death in a way that most of us do not until we are much older. Being exposed to the existentially expected death of an elder is one thing. Facing the death of someone closer to our own age can leave us feeling even more threatened and insecure.

It’s jarring to realize that we aren’t immune and it really can happen to us. Blissful ignorance of threat can be adaptive, and having that illusion of safety lifted can be traumatizing in and of itself, leading to a sense of impending doom.

It never ends…

As the child ages toward adulthood, there can be a feeling that life is never allowed to be “normal” again. The cloud that comes with the death of a child in the family follows them through every meal, every trip, every holiday and gathering; their absence can’t help but be felt.

Then there are all the anniversaries of the death, when the child would have graduated, going to the weddings of the child’s friends, and on and on. The potential for triggers are constant. It is a heavy burden under which to grow up. And then to be an adult caring for aging parents without the added help the sibling may have been, yet another reason to feel put upon or abandoned.

Some do not see it that way. They find meaning in all of it that gives them hope and even a life purpose. They find comfort in the deeper perspective, wisdom, and compassion that can come from being around death and suffering.

Whatever your experience, I’m certain I’ve not comprehensively captured it here. The hope is to prompt persons to have a deeper understanding of what the experience of sibling grief might be like so we will all be less likely to ignore or miss supporting a grief that often remains faceless and hidden.

How to be present for a grieving child…

If you are around a child who’s sibling has died, here are a few quick tips to remember:

As always, avoid cliché’s or imposing theology or meaning on a child.

Do NOT use euphemisms like, “They went to sleep” or “on a trip” lest they freak out the next time they or a loved one gets sick or travels. Use the real words.

Don’t force or push them to talk. Leave blank paper and colors or colored pencils around for them to draw or write. Perhaps ask them to draw a picture for their loved one or of what they think it is like for their sibling now. Invite them to write their sibling a letter. Allow them to place the picture, letter, or other tokens in the casket with their loved one if they wish.

Children learn and process their feelings through play. They may even play “coffin” or “death”. Don’t be alarmed. This is normal as they try on what it might be like for their sibling. So long as they aren’t scaring themselves, its usually helpful.

Don’t force anything. If the child is 5 years or older, we typically suggest allowing them to decide what they want to do about the funeral or memorial service. If they are under 5 years, parents are encouraged to make the decision they feel is best, knowing what they know about the child.

If a child insists on being present but is denied, they can feel left out or like there is a secret happening that can be far scarier in their imagination than in reality. If they don’t want to go and they are forced, it can be traumatizing. If they do go, have a safe adult prepared to focus on them, while other grownups are grieving and distracted.

If you know the death is coming, have a special box of toys and coloring books prepared that are new to the child. Have a grownup with whom the child feels safe prepared to focus their energy on being present with the child somewhere nearby, but out of earshot while other grownups may need space to grieve openly in a strong way that may scare the child.

Refer questions to the parents. You’ve no idea what the parents wish to teach the child about why bad things happen or what happens after we die. Confusing the child with multiple messages is not helpful.

Get comfortable saying, “I don’t know”. You don’t have to have all the answers.

Don’t tell a child G-d did this, lest they learn to resent or feel afraid of a deity.

Don’t tell the child, “You have to be extra good/strong/brave/etc.” No, the child has to be a child and grieve exactly as they need to without grownup expectations being put upon them.

Be present, be open, don’t over-share horrific or graphic details, stay calm, and give them room to talk or be quiet or play or vent whatever emotions come up for them.

Again, this is far from a comprehensive list. Being with a sibling of a child who has died or is dying can be challenging, but the gift of simple presence can remain with that child for a lifetime, because someone refused to let them be invisible.

Trust yourself. You’ll do better than you think.

Peace,

Carla

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Parental Grief: Day 23 of #31DaysWithGrief

Posted by Carla Cheatham on

January 23, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 23—Parental Grief

As close as I can understand…

I tread gently when speaking of any grief I have not personally experienced. I did learn how amazing it is to love a child as a step-parent over a period of years.

I will never regret a single 2:00 a.m. wake up because of a nightmare. I’ll never begrudge even a moment of gently holding back her long hair with one hand as she puked up her toenails while worriedly calling the doctor for an appointment with my other. Every second was worth loving her.

I got a small taste of what it is like to lose a child when my relationship ended and I had no legal right to see this small, funny, brilliant, kind, beautiful human whom I absolutely adored. I did not give birth to her, but I felt the umbilical cord cut, grieved deeply, and miss her still.

As much as it hurt, and it did hurt too much to breathe for a very long time and I still get misty-eyed and choked up when I speak of her, I took comfort in knowing she was still alive. I imagined the others who would come into her life to love her. I prayed for her daily, and do still. I smile when I remember moments and antics. I wondered about her learning to drive, what high school was like for her, where she’s chosen to go to college and what she’s finally (for now) decided she wants to study and do and be for her career.

For me, knowing she was and is still in this world, and trusting the universe to care for her made it all easier to accept, because I trusted she was happy, had a future, and that perhaps I may even get the chance to see her again someday.

I can barely imagine that pain being even an ounce bigger by having to live with the death of a child.

We don’t compare pain, but acknowledge each grief’s unique features…

In Sharing Our Stories: A Hospice Whispers Grief Support Workbook, I wrote the following:

“We don’t compare grief, lest a person minimize their own pain if they believe it to be somehow less challenging than another’s experience. For example, some may say, ‘Oh, they’ve had it much worse than I have.’ This can lead a person to not feel as if they have a right to grieve as deeply or as long as they may need to. It can also leave them feeling guilty or ashamed about how they feel….

While we do not compare, there are forms of grief that have unique characteristics that challenge us in diﬀerent ways, such as grief related to a trauma or a sudden death. The death of a child or other young person can pose such a challenge for us…

It is natural for humans to think that parents will not outlive their children. When it does occur, it poses an existential challenge—something that ﬂies in the face of how we believe the world should be, how we make sense of things, and how we understand questions of existence and meaning and suﬀering. We may hear, or find ourselves saying, ‘Parents should never have to bury a child,’ or ‘Children should be able to grow up and live out their whole lives.’”

(from Sharing Our Stories, pg. 99-100)

Because the death of a child can so challenge our sense of the way the world should be, our defense mechanisms may come up even more strongly to try to make sense out of it all or to decrease the impact we feel about it. But we must guard against our discomfort causing them even more damage and trauma.

What to avoid when speaking to a parent who is grieving…

Here are a few things to remember when interacting with parents of children who have died, whether before or after birth:

Children who are stillborn or miscarried are no less valued and no less loved by their parents. Do not minimize this loss. Honor the death and find ways to show up well for these parents, as this form of grief commonly falls in the category of Disenfranchised Grief.

Ask, “What is their name?” The child is still very much present in their parents’ hearts and minds, so referring to them in the past tense can feel harsh or disrespectful.

If you do ask about the child’s age, be sure to NOT make it appear in any way that a younger age makes it somehow less traumatic to the parent. This is minimizing and dismissive. It can be tempting to use this information to feel like, “Oh, well they were only 2 months old, so that mustn’t have been that bad. I mean, it’s not like they…(insert excuse to make the pain not that bad, here).” Don’t injure them further by saying such insensitive things to decrease your discomfort. As I wrote in Sharing Our Stories, “Grieving parents often state their child’s life cannot be measured in hours, days, or years, but by the love their presence generated in the world—however long they were physically with us.”

Do not tell the parent in any way how they should feel, what they should think, what they should believe, or how they should act or respond. There are no right or wrong answers here, or with any grief. Each person must do whatever they need to find peace and meaning and should never have meaning imposed upon them,

Examples of imposing meaning, as well as cliché’s and theologizing to avoid, are:

“God needed another angel.”
“God was saving them from some worse experience later.”
“They were too good for this earth.”
“Well, at least you have (or can have) other children.”

There are more, but any parent whose child has died is probably ready to scream right now being reminded of or hearing these, so I hope this gives you an idea.

As always, if a parent’s form of coping is to believe any of these, it’s okay to affirm their feelings and beliefs that are getting them through, but make certain such words come from THEM. If it’s not helpful for them, the opposite of not helpful isn’t benign, it’s traumatic and damaging. Don’t risk it.

It is always safe to say, “I wish I knew what to say. I’m so sorry I don’t. But I care and I’m here, however and whenever you need.” Then follow that statement up.

Offer to run an errand. Offer to care for the house/kids/animals/yard. Invite them to lunch and be prepared to listen the whole time if they need to talk, without needing to jump in and speak over them. Let it be their space.

When you leave messages, make it clear that there is no pressure for them to respond, but to do so only if it is good and helpful for them; that you won’t take it personally, at all, if they do not do so. Let them know it is a simply given offer with no expectation on them in any way. And mean it!

So much more to say…

There’s so much more that could be said. Whole books and blog series and websites are devoted to this topic. For now, I will leave you with one of the many poems contributed to the Sharing Our Stories grief workbook by Janie Cook.

Janie’s own son, Matt, died of depression through suicide that claimed his life in 2007. She graciously offered her work to me from her blog, LivingWithTheLossOfaChild.blogspot.com:

First you try to take in all that is lost . . .
the dreams that will never be,
the deafening absence,
the precious reminders of the presence of this child
that literally rip a hole in your heart each time you see them
and, at the same time, you try to take in all the amazing gratitude you feel . . . ,
for the unforgettable moments you have been given,
for the vivid memories that replay like a beloved movie in your mind, and
for the amazing gift of a love as immense as this ?

Janie continues:

Grief is so confusing! It is packed with both of these heavy opposites. So, we careen from one to the other like a marble in a pinball machine – bouncing first one way then another. It is enough to make you crazy! It does make you crazy.

I carry an image in my mind of what healing looks like. It is standing with both feet planted firmly on the earth, arms outstretched, palms up . . . holding the son I have lost in one hand and the son I have been so graciously given to love in the other.

In my better moments, I am balanced between these two truths. And, I believe that healing is learning to keep this balance until it becomes so familiar to us that we do it without thinking. . . . gently holding one reality and then the other . . . . accepting the truth of both.

~Janie Cook

May those who love someone whose child has died find support to help you support them. May those of you who know what it is to face the death of a child find comfort and peace as you find your way in your own time.

Blessings,

Carla

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Loss After Crises and During Chronic Grief: Day 22 of #31DaysWithGrief

Posted by Carla Cheatham on

January 22, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 22—Sense of Loss After Crisis & During Chronic Illness

In my last post, I wrote of the impact of not just the primary losses we experience, but also the secondary losses of safety and security, connection and identity, future hopes and dreams, etc.

I’ve also written about Disenfranchised Grief, that which is not known about or understood by others, leaving the one grieving a loss even more alone, and even feeling judged.

Both dynamics come into play after a person has gone through a crisis that has seemingly resolved well and when persons go through chronic illness.

In the former, folks wonder, “It’s all ok now! Why are you still so freaked out?” In the latter, persons don’t understand what chronic illness does to a person’s physical self, emotional and mental health, relationships, income, and so on. Failing to understand fully what it’s like, they get impatient and/or judgmental with the person who is already suffering.

More of my story…

In 2012, as I’ve written before, I was preparing to compete in an Olympic distance triathlon. I began having shoulder pain my doctor feared was coming from a neck injury when I was rear ended in my car a few years before. She ordered and MRI that came back with some incidental findings—one kidney was dead, the other was inexplicably enlarged, and I had solid (read: possibly cancerous) masses on my uterus and ovaries.

I’ve always been fairly healthy. I was running 20-25 miles a week, biking 90, and swimming 5. I was about to do a century (100 mile) ride. I had a race to run. I did not have time for this. It wasn’t on the agenda! I told them to close the hood and stop looking.

But my life changed overnight as we tried to decide where to start. I gained 6 new specialists overnight and had 20 hours’ worth of doctors’ appointments a week as we did scans and tests and tried to figure out what was going on and what to do. In the meantime, my shoulder/neck injury worsened and became almost debilitating.

Yeah, it was a rough few months.

The end result was that I was mostly ok. There was no cancer and almost everything was treatable. That which wasn’t was mostly live-with-able. I didn’t have cancer! I should have been jubilant and relieved. My kidney was dead not because of some scary disease, but because a doctor made a mistake during a surgery over a decade before. The other was only enlarged because it was doing double duty, giving me 100% kidney function.

When it was “over”, it wasn’t really over…

I couldn’t understand why I still felt like, pardon the term, total shit. I wasn’t relieved. A doctor, who was supposed to treat me, damaged me irreparably, and either lied about it or missed it. Another surgeon tried to hide it from me. I felt betrayed, but had no legal recourse due to tort reform. What if my remaining kidney fails? What if I have to go on dialysis?

So what if it wasn’t cancer this time? The fact that I had sat in an oncologist’s office not as a healthcare professional but as a patient, a particularly sobering moment for me, had me worrying about tumors growing quietly inside me until it was too late. Sitting with the worry for almost 5 months before surgery revealed it was not cancer took a toll on my psyche.

The surgery that took care of the solid masses, that weren’t cancerous, required a partial hysterectomy. I had not yet give birth to children and, at 42 years old, had still been considering it. That option was now gone for me.

I was behind at work. I was behind on everything at home. Despite having insurance, that many co-pays decimated my savings. I was emotionally and physically and mentally exhausted. My adrenals crashed, as they tend to do AFTER a crisis is over as I’ve written previously, and the partial hysterectomy threw me into menopause, causing 30 pounds weight gain and lots of muscle loss almost overnight.

Did I mention already I was 42? Did I mention I was about to run a mid-distance triathlon and do a 100 mile bike race? I missed both of those. It was even more loss of my identity as an athlete and someone who was physically and emotionally strong.

The inner recovery took longer than the outward…

I could not get my confidence and sense of safety back for a long time. I had lots to grieve. I had come face to face with most people’s worst fears. I had dealt with loved ones not knowing how to respond and so disappearing in response.

I had dealt with the well-intentioned but totally unhelpful things people said such as, “But people live with one kidney all the time!” My response became, “Since you think it’s such a good idea, when are you going to donate one of yours?” That usually helped them do some perspective-taking and get a bit of an idea about how I felt, and they realized how thoughtless and dismissive that statement was.

So when a friend of mine, another hospice chaplain, recently went through her own medical scare and the result of the surgery was, “We got it all”, I understood her when she said, “Folks don’t get it why I’m still feeling skittish and am not rejoicing that it’s all over. It’s not over! Cancer was inside my body, and no one seems to get what that does to a person.”

The dynamics of chronic illness can be similar…

Persons who live with a chronic illness were probably nodding their heads in understanding during much of what I wrote above. The dynamics can be similar—the impact on work, relationships, dreams and plans, finances, mental and physical and emotional energy and clarity, dealing with persons’ impatience and lack of understanding and even judgment and blame—should I keep going?

Others’ suffering doesn’t end on our timetable, when we need it to be all nice and neatly over and resolved and tied up with a pretty bow of celebration saying, “Whew!! Glad that’s over!!” so we can feel better. When our patience or ability to sit with suffering ends, that isn’t the time to tell them to hurry up and get over it because we have become uncomfortable with their discomfort.

If we don’t have any more to give, we can make our excuses and step back to regroup. We can find ways to be supportive that we can handle so we don’t abandon those around us who are hurting. Certainly, we can’t carry all of the world’s hurts or even all the pain of all those around us. But we also can’t abandon everyone all the time. We must find some ways to show up and be of support, even by just saying, “I care. I’m here.”

Do what you can, but never rush, never judge, never condemn, never blame the victim, and never condescend to those who are hurting. When we want to accuse them of making too big of a deal out of something or attention-seeking or faking it, that’s our issue, that’s our shame, not theirs. Check our own motives for needing to cast someone off that way.

Certainly, we should not allow others to guilt us or manipulate us into care-taking or doing more than we feel is appropriate, but we must always check our motives and be mindful of our words.

Taking care of ourselves, and each other…

If we are the one struggling during or after a medical or other crisis, as always we must discern carefully whom we can trust with our vulnerability. Avoid or say little to those who have not earned that precious right. Set boundaries where you feel you can and need, and focus instead on those safe spaces you can turn with folks who get it and will affirm and encourage and never judge you.

I am SO grateful that I did have those to whom I could turn. They were lovely. But I learned a great deal about how important it is to be intentional about building that kind of community, and I got even better at it during that time. So start now building those safe spaces if you do not have them, and see if any part of you feels called to be a better part of such safe space for others.

We, and those around us, deserve it.

Peace,

Carla

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Primary and Secondary Losses: Day 21 of #31DaysWithGrief

Posted by Carla Cheatham on

January 21, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 21—Primary and Secondary Losses

“So much of my time, energy, and identity has been wrapped up in being an architect. After my injury, I’m legally blind and can’t see to do the work that’s been my life’s calling, and I was GOOD at it. Who am I, now? How do I adjust to suddenly not going into work every day with my colleagues who are also my friends? Who am I now that I’m not the breadwinner and provider? How do I feel like I’m taking care of my family, now?”

“So much of my time, energy, and identity has been wrapped up in being Evelyn’s son. Caring for her after dad died and after her stroke has consumed our lives. Though we were tired, the family of folks here at this facility are now part of our everyday routine. My wife comes on the way to work to say hello and bring her laundry. I come and help her eat lunch and visit with the staff and her friends, and we come 3 nights a week to watch television and listen to music with her and the other residents and even their families. This is our second living room. We all supported each other. I don’t know how to say goodbye to not just her, but this whole community of people we’ve come to love. Where am I supposed to eat lunch during my break? It’s just so weird to lose it all at once.”

“So much of my time, energy, and identity was wrapped up in being Scotty’s mother. Now that he’s dead, I don’t know who I am any more. My nest isn’t supposed to be empty, yet and, when he did leave, it was supposed to be to go excitedly to college and figure out who he wanted to be, to fall in love and find his life’s passion in his work. Then I could watch proudly from the sidelines and cheer him on. He was supposed to have children and I was supposed to get to see him be the fabulous father and spouse I knew he would be, and I would adore the person he loved and their babies were supposed to come and fill the empty space on my lap. Now ALL of that’s gone.

When we experience a loss of any sort, it usually involves not just the primary loss of the thing, ability, relationship, or person we’re grieving but also the secondary losses of identity, routine, security, provision, and so much more.

We often do not recognize these secondary losses and realize their impact until they are already sorely felt. Others around us also fail to notice them and therefore forget to care for that part of our grief, as well. Because they don’t quite get it, they may not be as sensitive to these secondary losses as is deserved, so we can feel even more isolation and shame.

Caring professionals are, or should be, trained to predict and notice these secondary losses and help persons prepare for and cope with them. When I ask the questions, “What are you going to miss the most about your dad when the time comes that he does die?”, I’m not just inviting them to process their grief, but listening for cues as to the secondary losses they are going to experience.

So often, loved ones respond that they are going to miss just being able to pick up the phone and call them. Those grieving often tell me how many times they pick up the phone or think, “Oh, I need to tell mom about that, she’ll love it!” just to realize she’s not there to call anymore.

Many of us have a routine; we call her every Sunday afternoon and Thursday evening to check in and visit every other Tuesday when we take a half day off work. Or we have an empty seat at the table we aren’t sure what to do with. And what about their things?

One woman woke up, made coffee, and cooked eggs. “I was fixing two plates before I realized, he’s not coming downstairs to join me for breakfast anymore.”

We help persons think through what routine they want to adopt next. What have they wished they had time for but did not? What’s on THEIR bucket list? How could they perhaps honor the memory of their loved one by picking up something that would carry on their legacy?

Who is that loving friend who will agree to take a phone call every Sunday afternoon, Thursday evening, and have lunch every other Tuesday to listen to you tell stories about mom until you find a new normal in your life?

Who is willing to be your new “go to” person to call for a while to feel connected and share good news or when you’ve had a bad day or just need to pick up the phone and call?

Without skipping over your grief with busyness, how about taking that art class or joining the choir or signing up to be a reading mentor at a local school?

The goal isn’t to replace or forget about the person or relationship or ability or thing you’ve lost, but to find some sense of meaning for yourself, perhaps even in a way that helps you remain connected to what’s been lost.

“Mom was a teacher. She would like that I’m helping kids read.”

“My son loved nature. Volunteering at the community garden helps me help others enjoy what he most loved.”

“We used to dance wherever and whenever, just for the heck of it, before I found out about the affair and we divorced. I signed up for dance lessons. He’s taken enough. He doesn’t get to take that away from me, too.”

And the man who was an accomplished architect? His colleagues dragged him kicking and screaming into teaching, and he wound up loving every second of it for two more decades!

You’re not filling up a hole, you’re filling up your life. You’re not replacing them, you’re finding a way to find meaning in the midst of your loss and maybe even connect with them, or yourself, in a new and different way.

Whatever you choose to do, find ways to acknowledge what else has been lost and find others to be sensitive to these secondary losses. Grieve them, care for them, and find ways to heal them in time. As overwhelming and impossible as it may seem, there is still hope for finding a new normal, perhaps one you never wanted, but maybe one that contains joy in ways you never could have imagined.

Peace,

Carla

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Compounded and Collective Grief: Day 20 of #31DaysWithGrief

Posted by Carla Cheatham on

January 20, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 20—Compounded and Collective Grief

This post is a bit longer than most in this series, because I’m touching on several topics—compounded grief, collective grief, compassion fatigue, and adrenal fatigue. I hope something in this is helpful for you and for those about whom you care.

It’s been a tough year…

Each year, I look forward to the nostalgic retrospectives on television that review the world’s major news stories and honor the celebrities and other national figures who have died. But this year, I couldn’t! There’s just been way too much.

Beloved musicians who gave us the soundtracks of our youth or helped us have hope during hard times; gentle-faced tv moms who served as a surrogate and role model for many; those who made us laugh and believe in chocolate-coated dreams; villains of stage and screen we couldn’t help but love; newscasters whose calm voice helped us feel safe during challenging times; and even sci-fi heroines who reminded us that even princesses could be, well, badass…the grim reaper has been working overtime in 2016.

Add to this the killings of both black and blue and brown, world crises, acts of terror, and one of the most contentious political seasons in recent history, and we’re all more than a little wiped out.

We often don’t recognize Compounded Grief…

What many are dealing with, but don’t realize it, is not only compassion fatigue, but also compounded grief.

Compassion fatigue, in short, is when our caring muscles are worn out and need rest and care to heal and recharge.

Compounded grief is the phenomenon of facing multiple griefs that come faster than we can process them, so that 1 plus 1 no longer equals 2, but instead multiplies exponentially until our grief muscles simply can’t carry them all.

Another thing to consider is that the exhaustion that comes with stressful times doesn’t always hit us during the stressful event. Our adrenals kick into high gear to take care of us and keep us going. It’s a normal and adaptive response to stress.

Eventually they give out, like anything else, and need time to rest and recover. This is known as adrenal fatigue, and is common, but what most don’t realize is that they don’t tend to conk out in the middle of our stress, but wait until the stressful time is over and THEN decide to go on sick leave.

That’s why many are caught off guard that they initially feel better after a period of stress has passed, only to hit a wall and crash hard on the couch a couple of days or weeks later. The adrenals have quietly gone on strike and said, “Yay! Now we can nap for a while”, leaving us even more worn out that even before.

Collective grief can add to the challenge…

Compounded grief takes a toll on us emotionally and physically, yet we’re rarely prepared for or aware of this and think something is wrong with us, that we’re being wimpy or weak or dysfunctional. With so many in this country experiencing compounded grief from this challenging year without even knowing it, we’re also subject to the impact of collective grief, where those around us are also grieving. Just being in the proximity of so many who are suffering can take an even greater toll on us.

In some ways, collective grief is helpful because we may have more space to process with others who are just as ready to talk as are we. It also helps to not feel alone when we’re mourning. But just like different members in the same family can grieve a loss in very different ways, so too do we see various coping styles from those around us. Some get quiet and pull away while others get loud and angry, with every other type of coping in between represented.

Being around that much grief expressed in that many ways can be more overwhelming than helpful. We must be careful with our exposure to conversations at gatherings and on social media, even in the news, and take in only what seems to be helping us cope and process and turn it off or kindly walk away when it’s counter-productive for our sanity, health, and relationships.

When we’re already tired…

For those who are already dealing with grief in their personal lives, any additional stress can be more than they can bear. Being around this compounded and collective grief many in our country are experiencing and expressing may be intolerable to add to their already heavy load. Remember, our compassion muscles are already overloaded and fatigued, so we have less to give others.

We’re so weary from walking with our own stories that we can’t carry anyone else’s.

This may lead our defenses to kick in and offload being around others’ grief, which can look like being impatient with or shaming of others’ pain and frustration. We can’t do that! We must learn a way to take grief out of the shadows and release it from the added burdens of disconnection and shame. The only way we can do that is together.

This is a natural response to inordinate circumstances…

So if you’re struggling more than you think you should, if you’re exhausted more than seems reasonable, if you’re cranky and crabby and not fit for human consumption because of your impatience and overload, please hear me—you are crazy.

Words exist for what you’re feeling and going through. You are not weak or too emotional and you definitely are not alone. You are simply a normal human being going through an abnormal time of compounded and collective grief that is far greater than what we’ve experienced since 9/11 and its aftermath.

The most healthy and tough and mature and boundaried of persons will crumble when pushed far enough. Often we hold ourselves to such a high standard that we are shocked and caught off guard and can’t figure out what’s wrong with us when we’re experiencing a natural response to an unnatural compilation of events.

Be gentle, with yourself and each other…

Be extra protective of your emotions. Be aware of the music, television, post casts, news casts, and social media to which you’re exposing yourself. Your ability to filter out harsh or negative words and sounds and images is probably weakened and your already heavily overloaded emotions can’t handle as much these days, nor should they!

I was at the blessing of twin babies last night. It was happening earlier than was probably wise for these two preemies, whose immune systems are still developing, but it was the only time many family members could see them before they traveled back to their home state.

The daddies held them closely in chest wraps and pulled the soft cloth back briefly so loved ones could catch a peek and say hello to the newest members of the family. Some loved ones stayed home from the party because they had a cough, most likely due to the awful allergy season we’re facing, but they didn’t want to take any chances at having something that might drift to the babies.

No one complained that any of the group was being overly protective. Love doesn’t make everything about us, but wants what is healthy for the other. No one judged the infants for not having a strong enough immune system, yet. Love doesn’t shame or rush another’s process.

When did we decide that taking good care of grief and being tender with tender hearts was weak? Take just as good of care of yourself as you would the most beloved persons in your life.

Soft fabrics, quiet space, yummy foods (though be mindful of the ways that alcohol, sugar, and caffeine can dehydrate and depress our systems), sunshine, puppies and kitties or your pet iguana—surround yourself with whatever you need. Move a little, even just 10 minutes, to get oxygen to your brain, but don’t overdo it; those adrenals and your brain and body need all the resources they can get to recover and process the stress of grief. Give them that.

Be slow. Be safe. Pay extra attention. Your brain can be fuzzy-brained and distracted, processing grief in the background of your mind as you go about your day, often behind the wheel of 1-ton machinery going 80 miles an hour, surrounded by others who are also grieving and wiped out.

Whatever you do, simply be gentle and tell any shame gremlins that start to bite at your ankles that there is no shame in being normal and everything right about being human. After all, if we can’t sit with and have compassion for our own pain, how can we even begin to be able to be with others?

May we all find our own ways to care wisely for our grief and be compassionate with ourselves and each other as we all seek to heal and recover.

Peace,

Carla

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Don’t Let Anticipatory Grief Rob You of Today: Day 19 of #31DaysWithGrief

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January 19, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 19—The On-Going Pain of Anticipatory Grief

One of my favorite lines of writing comes up often from one of my favorite writers, Anne Lamott. In describing a situation in which she is waiting for the other shoe to drop, she remembers…

“But I think God only has one shoe.”

I lived with this feeling of waiting for the other shoe to drop even after a health crisis passed (I’ll write more about this in a later post). It so permeated my days that I finally looked up the origin of the saying.

The expression came from a common vaudeville comedy show in which a person checked into a boarding house late at night in an upstairs room. After noisily letting his first shoe clunk heavily to the floor, waking the patron below him, the now awake man below wanted to go back to sleep, but couldn’t because he knew the other was coming at any moment to just wake him, again.

When the tension of waiting finally stretched to its breaking point and comedic climax, the man in bed finally yelled to the ceiling, “Well, whatcha waiting for?! Go ahead and drop the other one!”

It’s funny because it’s universal. We all know what it’s like to anticipate the tickling fingers of an older sibling who’s playfully teasing us, the butterflies before a first kiss, the “what the heck was I thinking” stomach swirl as the roller coaster clicks in a painfully slow way up the hill just to pause before dropping us to massive speeds over the other side, or the first steps up to speak for a major presentation. Those are the fun ones we choose.

Others aren’t so fun. Sometimes, we wait to see what his mood is going to be like today when he comes home, to hear what the boss has to say when we’ve been called into her office during layoffs, for the doctor to call with the results, for the day to finally come when dad doesn’t recognize us.

We hold our breath without realizing it (which science tells us triggers our bodies to register even more anxiety and fear, so we need to keep belly-breathing!). We freeze or we pace or we prattle or we get busy or we numb to try not to feel the dread.

We just want to get it over with while simultaneously wanting that moment to never come.

The stress this whole process of anticipation puts our minds and bodies through can do great damage. We’re not designed to live under constant threat with on-going cortisol flooding our systems and hyperarousal pushing even our amygdala to enlarge and overwork even more. It takes a toll.

For some, this time is received as a bit of a gift, in that, by the time the shoe finally drops they’ve already grieved and prepared so much that the impact isn’t quite as traumatic as they expected. It’s like an emotional forced savings account that makes it a bit easier when the loan is called to not have to make the payments all at once; we’ve been paying little by little, day by day.

Certainly, that’s not always the case, but when it is, it can surprise us to realized we’ve already cried out all our tears. Some even feel guilty when they have no more tears left to cry and, instead, feel a flood of relief that it’s over. But when “it” is the death of a loved one, the relief can feel weird to experience. We in healthcare spend a lot of time reassuring folks there’s nothing wrong with being relieved that suffering, our loved ones’ and our own, is over.

Until that time comes and the shoe does finally drop, it can be easy to miss those moments as we are distracted by the dread of what is likely to come. In fact, we can so dread tomorrow that we lose today. Finding a way to cope with anticipatory grief is important. We’re already being robbed of enough and deserve whatever time we have to find some connection and peace.

One gift, again hard-earned and one we don’t really want, of working with persons who have dementia is the constant invitation to be present with what is in each moment, since things can change and vacillate so quickly and often. It’s definitely a practice to sit and breathe and be with what is, while working to accept each moment. Sometimes, it’s the only way to sanity.

The waiting, the dreading, the anticipating are all natural and understandable. You aren’t crazy. You aren’t alone. You will get through this. And, it will likely suck. Take good care of yourself and find ways to cope with the stress of waiting so that you can soak up the moments you have left.

As always, find those who can walk with you as you walk with your grief. No one should ever walk with grief alone.

More information about this topic can be found on the fabulous site, What’s Your Grief, which I highly recommend and respect. I hope you find it helpful.

Until tomorrow…

Peace,

Carla

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Disenfranchised Grief Shouldn’t Be Missed: Day 18 of #31DaysWithGrief

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January 18, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 18—The Isolation of Disenfranchised Grief

In the Sharing Our Stories grief workbook, I had this to say about disenfranchised grief:

“Disenfranchised grief is that which is not known, acknowledged, or understood by society. When this occurs others do not know to oﬀer support (i.e., when a secret relationship ends) or they do not oﬀer adequate support out of a lack of understanding (i.e., after a miscarriage, death of a pet, or any time others begin to feel that someone should be over their grief within a certain period of time).

When a deceased loved one was challenging or even abusive to live with, most others around us will not know the private story. As a result, those who have been victimized may be reminded painfully of the original trauma, and the secrets that surrounded it, as others praise the one who perpetrated the abuse as a wonderful person, not knowing the damage he or she also caused.

Others may not realize the extra triggers and confusion that can occur when a person with whom we had a challenging relationship dies. As a result, they may not oﬀer us adequate support. What, if any, has been your experience of disenfranchised grief? What healing might you still be in need of that you could receive from others about this now?”

This was written as part of the reflection on the Hospice Whispers story, “Your Mom Is So Sweet” ©2014. It details one well-meaning volunteer who gushed about how sweet a patient was to the patient’s daughter, who had lived her whole life with her mother’s on-going abuse.

I don’t know your story (that’s what the sweet but inexperienced volunteer learned from this situation), but whatever it is it’s important to notice if any of your grief is in any way being sent, by you or others, underground. Is there any way in which your grief can’t be adequately processed through because it’s not sufficiently recognized, supported, or given safe space to be heard?

When I was a teenager, a close family member suffered from mental illness and saw enemies everywhere she turned. I was not allowed to openly demonstrate grief about the deaths of a friend and later a family member because she held so much against them that my grieving appeared to her like a betrayal and she squelched my tears harshly.

Others did not know this was happening. So I grieved the deaths largely in private and grieved the emotional abuse of the whole twisted circumstance completely in silence for many years.

It wasn’t until I began working with those who grieve (funny how we find what we need…) that I realized my need to go back and mourn these two deaths. Ugh! And yet, the relief and freedom I found on the other side of finally grieving all of this were well worth the price of admission.

Trust me. Find places to not be alone anymore with disenfranchised grief. It may be hard, but I promise, it’s worth it.

Peace,

Carla

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Don’t Pathologize the Anger of Grief: Day 17 of #31DaysWithGrief

Posted by Carla Cheatham on

January 17, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 17—Don’t Pathologize the Anger of Grief

I’ve previously written for my guest blog on Hospice Times a post encouraging professionals not to mistake or write off the anger related to grief as dysfunction.

It can be a lot easier to recognize and respond caringly to grief that involves quiet tears rather than loud rants. As a culture, we’re not comfortable with death and grief, but I would argue that our relationship with anger is even more unhealthy, no matter what the anger’s source. The grief that comes out in anger may not be warm and fuzzy, but it’s no less deserving of support.

Most of us would not fault parents for raging at the injustice of the death of their child. But how many of us could sit in its presence without feeling a little freaked out and, as a result, wanting to find some way to calm that anger down?

Many do not feel comfortable expressing their own grief, much less being around others’. Sometimes, however, in the midst of our grappling with our frustration and helplessness and angst over what seems so unfair or unjust, there is no putting a muzzle on grief. We must find safe spaces and ways to get it out lest it fester inside of us and cause further damage.

Think about how anger was/is handled in your family. Consider how the significant grownups who raised you expressed their anger and responded to others expressions of the emotion. Was it loud and scary, quiet and underground, passive aggressive and harsh, avoidant and rejecting? Of the methods of handling grief that you were raised under, which ones did you adopt? Which one is the hardest for you to be around?

The more we understand our own relationship with and perception of anger, the better we will be able to navigate it when it arises during grief.

It’s an understandable and even adaptive response to anger. Think about it, the energy behind anger can be the only thing getting us up off the couch when the depression of grief wants to permanently imprint our butts there! It can keep us going and moving and push us to find answers and make meaning out of the meaninglessness of loss.

So, if you love or care professionally for those who are grieving, explore your own comfort level with anger. Spend some time reflecting on ways to unhook from getting triggered, taking it personally, and moving into a flight or fight response so that you can comfortably give it safe space to be expressed.

Let only affirmation, normalization, and validation as your response. Those grieving get enough pushback from others and need somebody to finally just GET it and not push back. Saying, “Of COURSE you feel this way” can be one of the greatest gifts you can give. Top it off with, “This sucks” or “No, this doesn’t make sense to me. I wish it did” or “I wish I had answers, and I’m so sorry I don’t.” And always end with, “I’m here with you. You’re not alone.”

If you are grieving any type of loss, take a moment to check in and see if there’s any residual grief you’ve blocked, shut down, or explained away. Look around you for those who can handle sitting with you in it without having a reaction that makes you feel like you have to shut it down to take care of them and their discomfort.

Find persons who will not quietly or openly shame, judge, or dismiss your anger. Like it or not, it’s all part of it and it all deserves space to just be until it passes through in its own time.

Till then:

Breathe.
Remember that this will pass.
Remember the different between venting to and venting at another person.
Exercise to give your body some relief. The science shows that this helps.
Commit to not harming yourself or anyone else as you express your anger.
Let the scribbling of your pencil help you physically and emotionally process your feelings (again, there’s science behind this).
Write letters to the deceased, family members, G-d, the universe, or whomever else you need to tell all about it that you do not intend to send.
Burn these, shred them and cast them out onto moving water, or read them a professional or friend who can caringly listening without interjecting or trying to talk you out of how you feel.
Allow yourself to re-story the event in the way you wish it had ended. Look for your own sense of meaning in the story.
Do whatever you need to do that is safe and feels right.
Don’t forget numbers 1 and 2.

I’ll end here, but the struggle continues, and our need to respond well to anger remains. If you have insights or suggestions around this topic, I would value hearing them. Together, we’ll get even better at showing up for ourselves and each other when grief, understandably, pisses us off and draws our wrath.

Peace,

Carla

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The Pain of Long and Short Goodbyes: Day 16 of #31DaysWithGrief

Posted by Carla Cheatham on

January 16, 2017

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31 Days of Walking with Grief: Others’ and Our Own

Day 16—The Pain of Long and Short Goodbyes

We who counsel mourners regularly encourage persons to not compare experiences. Doing so can minimize one’s loss as being less significant than another’s, shutting down one’s willingness to grieve openly and receive the support they need and deserve. That serves no one.

This holds true for the varying time-frames over which a loved one dies.

Sudden, unexpected death can rock our world, leaving us feeling stunned in disbelief as we struggle to wrap our heads around what we do not want to accept as true. It reminds us that life can be capricious and that bad things do happen to good people, which can challenge all our existential beliefs and leave us feeling angry and afraid.

Having little to no time to say goodbye can significantly complicate our grief, as well, as the shock can take time to wear off.

The long, slow goodbyes of a protracted illness bring their own heartache and difficulties. Getting the chance to say goodbye is a gift paid for with weeks, months, or even years of watching someone you love suffer and go away bit by bit.

This prompts a series of griefs as we deal with the anticipation of waiting for the other shoe to drop, mourn each new loss, while exhaustedly and guiltily begging the universe to let it all be done.

Which would you choose?

Each person answers differently. It’s always interesting to hear both those who wish for the grass that looks so green on the other side and those who acknowledge how hard their circumstance is/was but accept it because of the gifts they find in their experience:

“I wish we could have said goodbye, but I’m glad he didn’t linger and suffer”.

“It wore us out in so many ways, but I wouldn’t trade a second of the time we had with her.”

Still others grapple with their lot:

“I can’t get over not having a chance to say I love you one more time. It haunts me, still.”

“Watching him suffer day after day was the cruelest thing I could imagine. It haunts me, still.”

We’ve no idea how someone views their situation, so we do not assume and we do not judge. We accept that pain is relative—the worst pain you’ve experienced is the worst pain you’ve experienced. There is no fair way to compare, and why would we? We let them be where they are and grieve exactly as they need.

What challenges did you find in your circumstance? What gifts did you come to see? What, if anything, remains for you to resolve for your own peace and sanity’s sake? What would it look like to be free from the things that hold you back? What would it take to get you there?

Whatever your grief looks like, however you answer these questions, I hope you find deep comfort and on-going support, exactly as you need it, and I truly hope this series is at least a small part of that which helps you.

Peace,

Carla

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