Saturday's Sayings - To Grieve is To Endure...

Saturday's Sayings

To Grieve is To Endure...

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All graphics, thanks to ~M for the Survivors on ~pinterest

Wednesday's Woe - Emotional Dodgeball ~Tommy Prince

Wednesday's Woe

Emotional Dodgeball

~Tommy Prince

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Nothing can get in the way of a joyful reunion in running into an old acquaintance as hearing the question, 

"So, how many children do y'all have?" 

"Three," I said.

"I guess they're all grown?"

(Short Answer) "Yes."

(Inside, I'm dying, pleading, Please Don't Ask Anything Else About Our Children!)

I immediately default to, "We have a wonderful grand baby," which then leads her and her husband  into telling how proud they are of their grandchildren. 

Then five, ten minutes later, by not encouraging her to keep talking about her grandchildren, the empty space was again filled with the dreaded question of,

"So how old are your children… they're grown?" 

Angie clued in to my sudden speechlessness and quickly said, "Yes, they're grown now."

Emotionally, I felt I was in the middle of a dodge-ball game, and I kept getting knocked in the stomach with a ball.

So I defaulted again to stories about our grandchild, which opened the door for her and her husband to tell stories about their grandchildren...

The context was that of being in the middle of a waiting room of a doctor's office, and running into this family whom we had not seen for over fifteen years, so it became obvious very quickly from their questions that they had no idea we had lost Merry Katherine. 

Her husband was in bad shape medically so we knew he did not need to hear any bad news, and I was about to find out what kind of shape I was in medically, so I knew I didn't need to get into anything painful either… 

I've experienced that conundrum many times where in sharing about Merry Katherine, it opens me wide up emotionally and I am then extremely vulnerable. 

I knew this was not the time nor the place for that conversation. But it surprised me, almost seven years into having lived with Merry Katherine's death, I felt so blind-sided that I essentially stumbled through that whole interaction as if I were totally unprepared for it. 

So much for "Time Helps"… We were taken back to square one in no time at all.

Graphics, thanks to Google Images

Saturday's Sayings - The Nature of Grief and Healing... - Part Two

Saturday's Sayings

The Nature of Grief and Healing...

Part Two

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You cannot rush your way

through grief. Grief unfolds

with the same exquisite

timing as the rose, left to

blossom on its own time, 

until the colors slowly fade

and the petals fall away of their own accord.

~Margaret Brownley

via ~Dr. Joanne Cacciatore

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I feel like this from time to time, until I recognize my grief simply mirrors my deep love and loss... 

and I realize, in feeling that intense love and loss, that it draws me closer to my child…

which draws me ever closer to God, crying out to Him...

as He draws near to me with His comfort and love...

and in such a place of grace and love, I feel that I am on holy ground…

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Where there is sorrow

There is holy ground.

~Oscar Wilde

There is a sacredness in the sorrow we feel when we lose our child. It is to be honored at all times.

~2012: Love and Loss and ~Dr. Joanne Cacciatore

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Somewhere in time, my beloved one,

Our hearts will meet again...

And what an extraordinary

moment

That will be..

~Dr. Joanne Cacciatore

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Graphics, thanks to ~Dr. Joanne Cacciatore, ~2012: Love and Loss, ~MISS Foundation (dot) org

Wednesday's Woe - Unresolved Grief, a Hidden Health Risk

Wednesday's Woe

Unresolved Grief, a Hidden Health Risk

In the following article from USA Today, experts say Unresolved Grief can be a risk factor that may contribute to other health problems:

• Jeopardizes our physical health

• Jeopardizes our mental health

• Creates injury (Often causes one to be accident-prone)

• Is suspected to be behind much of the nation's obesity, depression, diabetes, smoking, and hospitalizations

• Can kill people

• Creates a need for a greater degree of support in dealing with feelings after a person's death than grievers typically will get

• May cause feelings of guilt

• May cause feelings of numbness

• May cause fear

• May cause breathing difficulties

• May cause sleeplessness

• May cause anger

• May foster not caring for one's own physical health

• Poses a risk factor for having poor health 

Unresolved grief can be hidden health risk, experts say

Janice Lloyd, USA TODAY 10:13 a.m. EDT May 27, 2013

Grief is a risk factor that can contribute to other health problems.

Supporters line up to provide a motorcycle escort outside the May 24 funeral for 9-year-old torndo victim Nicholas McCabe in Moore, Oklahoma

(Photo: Tom Pennington, Getty Images)

STORY HIGHLIGHTS

• How we wrestle with grief varies among individuals
• Experts believe grief is linked to obesity, depression, diabetes, smoking and hospitalization
• There are no easy solutions, but finding support is crucial

Whether you lose a loved one to disease, war, or a natural disaster like the tornado that tore apart Moore, Okla., last week, grief is the unwanted visitor that comes knocking at your door.

How we wrestle with grief — and ultimately push ahead to a new life — varies among individuals. But many of us who need help to bounce back are not getting it, health experts warn, jeopardizing our mental and physical health.Toni Miles, director of the Institute of Gerontology at the University of Georgia, is embarking on a research project to find out how loss impacts health and what to do about it.

"Loss creates injury,'' Miles says. "It is a new risk factor for poor health in the public sphere."

Miles suspects grief is behind much of the nation's obesity, depression, diabetes, smoking and hospitalization.

"When you study caregiving, you know (grief) kills people,'' Miles says. "Obesity is also a big problem among caregivers. "

Finding support can be the key to a person's recovery and acceptance of the loss, says the American Cancer Society. Support can come from friends, physicians, spiritual leaders or mental health professionals. Everyone reacts differently to grief and for different periods of time. There's not one easy solution or answer, Miles says.

Getting the right amount of support is rare, according to a 2004 study on family perspectives on dying in the Journal of the American Medical Association. Lead researcher Joan Teno asked participants "during the last month (of their loved one's life), how much support in dealing with your feelings about a patient's death did the doctors, nurses or other professional staff taking care of him or her provide you: less support than was needed, about the right amount or more attention than you needed?''

Overall, 20% of the family members stated they did not have the right amount of support, and most said they got less support than they needed.

Teno, a professor of health services policy and practice in the Public Health Program at Brown University and a palliative care physician at Home & Hospice Care of Rhode Island, says her research shows families who use hospice at the end of life cope better than those who don't.

Donald Rosenstein, a professor of psychiatry at the University of North Carolina, is charting new territory into the bereavement process of fathers who lose their wives to cancer. He started a first-of-its-kind support group called Single Fathers Due to Cancer Program, part of the UNC Comprehensive Cancer Support Program.

"Everyone has a different reaction to grief,'' Rosenstein says. "We (health care professionals) don't have a lot of good information about how to get people to move on. But these fathers have been been teaching us."

Rosenstein says in addition to learning what the fathers need – how to discipline children by themselves, how long to wear their wedding bands, when is it OK to date, how long to call their in-laws in-laws — they're also learning how to help their children.

"For instance, moms always want to keep fighting and stay alive as long as possible for their families, but we're learning it's important for them to say goodbye," to provide a sense of closure for their families, he says. "We are also learning how much that helps the children and how to have that conversation with children."

Miles agrees that children are especially vulnerable: "Time doesn't heal all wounds,'' she says. "People in public health need to be discussing this topic more. There can be healthy outcomes from loss. It's up to us to help to find ways to make that happen more often and to push for policy that guarantees it."

ADVICE FOR DEALING WITH GRIEF

Grief is a typical reaction to death, divorce, job loss, a move away from family and friends, or loss of anything that is important to you, according to the U.S. Department of Health and Human Services:It can last from several months to several years, and can be accompanied by feelings of guilt, sadness or numbness. It might cause trembling, breathing difficulties and sleeplessness. It is also normal to feel joy and to express humor.

People who don't process their grief can become angry, guilt-ridden and fail to care of their health. 

Here are the four steps along the way to healing from grief:

• Accept the loss.

• Work through and feel the emotional and physical pain.

• Adjust to living in the world without the person or lost item.

• Move on with life.  {Note, Tommy and Angie say, in Child-Loss Grief, increasing resilience over time helps grieving parents to integrate more positive activities in their lives along with their grief. "Moving on" is not the goal, rather learning to live with the loss of one's child while continuing to embrace life. We recognize that Child-Loss Grief lasts for a life-time, but with good grief-work, over time the grief becomes gentler, and more manageable. Also, maintaining a relationship with your deceased child makes life more meaningful; it is generally recognized now that developing a "new" relationship with one's deceased child is more desirable that feeling such pressures as "moving on," or "letting go." Even Sigmund Freud agreed with this as when he lost his own daughter, he finally realized, there is no letting go, nor moving on, as you will always miss them.}

For more advice, an online guide to grief and bereavement is available from the U.S. Department of Health and Human Services.

"Healing" Graphic, thanks to ~Angels at My Door

Tuesday's Trust - Years and Years of Grieving... ~Angie and Tommy Prince

Tuesday's Trust

Years and Years of Grieving...

~Angie and Tommy Prince

Tommy and I were talking about the Bible the other day, and as we were talking about the story of Joseph being taken from his father and seemingly left for dead only to end up as second to the Pharaoh in Egypt, yet everything that is described about Joseph's father Jacob in thinking he had lost Joseph forever, described a man who had been grieving for years and years. He was so grieved that when Joseph's half-brothers asked their father if they could take Joseph's only full-blooded brother Benjamin with them to get grain from Egypt so they all wouldn't starve, Jacob refused and said if anything happened to this son, the only brother to his son he had lost, that he would surely be brought down to the grave in his grief. 

In walking through this story, Tommy heard me say the words, this father, after "years and years of grieving," and stopped me cold. He said, 

"Do you hear what you are saying?" 

And then we both exclaimed, Jacob, the man of God who fathered all the children that make up the twelve tribes of Israel, was certainly a godly man, and yet his grief over one of his twelve children had consumed him for years and years, and years! 

This icon of the Jewish and Christian faith, having had Abraham as his grandfather, and Isaac as his father, and then Jacob himself, God called "Israel"! Yet Jacob, the father of all the tribes of Israel, had been consumed with grief over his child for almost his entire lifetime. 

And these modern-day Christians think we are to be touched by fairy dust and zap, we should be OVER our grief? It is not going to happen… that is, until we see our child again… in Heaven. Jacob was bereaved his whole lifetime until he was rejoined with his son Joseph whom he thought he had lost forever. 

Think about it! God leaves these stories in His Word for our edification. No one needs to apologize for their life-long grief. Life-long grief is just what happens when we lose our child...

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Scriptures Revealing Jacob's Deep Grief:

~Genesis 42

3 Then ten of Joseph’s brothers went down to buy grain from Egypt. 4 But Jacob did not send Benjamin, Joseph’s brother, with the others, because he was afraid that harm might come to him. 5 So Israel’s sons were among those who went to buy grain, for there was famine in the land of Canaan also.

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29 When they came to their father Jacob in the land of Canaan, they told him all that had happened to them. They said, 30 “The man who is lord over the land spoke harshly to us and treated us as though we were spying on the land. 31 But we said to him, ‘We are honest men; we are not spies. 32 We were twelve brothers, sons of one father. One is no more, and the youngest is now with our father in Canaan.’

33 “Then the man who is lord over the land said to us, ‘This is how I will know whether you are honest men: Leave one of your brothers here with me, and take food for your starving households and go. 34 But bring your youngest brother to me so I will know that you are not spies but honest men. Then I will give your brother back to you, and you can trade in the land.’ ”

35 As they were emptying their sacks, there in each man’s sack was his pouch of silver! When they and their father saw the money pouches, they were frightened. 36 Their father Jacob said to them, “You have deprived me of my children. Joseph is no more and Simeon is no more, and now you want to take Benjamin. Everything is against me!”

37  But Then Reuben said to his father, "You may put both of my sons to death if I do not bring him back to you. Entrust him to my care, and I will bring him back."

38 But Jacob said, “My son will not go down there with you; his brother is dead and he is the only one left. If harm comes to him on the journey you are taking, you will bring my gray head down to the grave in sorrow.”

~Genesis 43

{After their grain had run out, and they were afraid they then would starve, Jacob remitted from his stance…}

13 Take your brother also and go back to the man at once. 14 And may God Almighty grant you mercy before the man so that he will let your other brother and Benjamin come back with you. As for me, if I am bereaved, I am bereaved.

~Genesis 44

19 My lord asked his servants, ‘Do you have a father or a brother?’ 20 And we answered, ‘We have an aged father, and there is a young son born to him in his old age. His brother is dead, and he is the only one of his mother’s sons left, and his father loves him.’

….

25 “Then our father said, ‘Go back and buy a little more food.’ 26 But we said, ‘We cannot go down. Only if our youngest brother is with us will we go. We cannot see the man’s face unless our youngest brother is with us.’

27 “Your servant my father said to us, ‘You know that my wife bore me two sons. 28 One of them went away from me, and I said, “He has surely been torn to pieces.” And I have not seen him since. 29 If you take this one from me too and harm comes to him, you will bring my gray head down to the grave in misery.’

30 “So now, if the boy is not with us when I go back to your servant my father, and if my father, whose life is closely bound up with the boy’s life, 31 sees that the boy isn’t there, he will die. Your servants will bring the gray head of our father down to the grave in sorrow. 32 Your servant guaranteed the boy’s safety to my father. I said, ‘If I do not bring him back to you, I will bear the blame before you, my father, all my life!’

33 “Now then, please let your servant remain here as my lord’s slave in place of the boy, and let the boy return with his brothers. 34 How can I go back to my father if the boy is not with me? No! Do not let me see the misery that would come on my father.”

~Genesis 45

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25 So they went up out of Egypt and came to their father Jacob in the land of Canaan. 26 They told him, “Joseph is still alive! In fact, he is ruler of all Egypt.” Jacob was stunned; he did not believe them. 27 But when they told him everything Joseph had said to them, and when he saw the carts Joseph had sent to carry him back, the spirit of their father Jacob revived. 28 And Israel said, “I’m convinced! My son Joseph is still alive. I will go and see him before I die.”

~Genesis 46

...

 29 Joseph had his chariot made ready and went to Goshen to meet his father Israel. As soon as Joseph appeared before him, he threw his arms around his father and wept for a long time.

30 Israel said to Joseph, “Now I am ready to die, since I have seen for myself that you are still alive.”

~Genesis 48

11 Israel said to Joseph, “I never expected to see your face again, and now God has allowed me to see your children too.”

Pictures, thanks to ~Angel Graphic Corner and ~SafeHaven For Widowed

Thursday's Therapy - Complex Grief, Depression, or Bereavement? ~David Joel Miller, LMFT, LPCC

Thursday's Therapy

Complex Grief, Depression, or Bereavement?

~David Joel Miller, LMFT, LPCC

Is it Complex Grief, Depression, or Bereavement?

Posted on April 22, 2012

~David Joel Miller,

Marriage and Family Therapist, Licensed Professional Clinical Counselor

Just what is Complex Grief, compound grief and why have people been asking about them recently?

Complex grief is also called complicated grief, traumatic grief, prolonged grief, chronic grief or extreme grief.

The Idea behind Compound grief and its many other labels is that while most everyone experiences grief at some point in their life, sometimes that grief becomes debilitating and people with these issues need help. The questions become, is this a mental illness and how should people with severe grief issues be helped.

One thing therapy shouldn’t do is turn everyone into a mental patient and start requiring treatment for all. In professional lingo this is called pathologizing clients. There is plenty to do helping people who genuinely need help so we don’t need to enlarge the number of disorders just to keep counselors busy.

Grief is a normal part of life. People we love die. The loss of a close family member should make you sad. When does this move from a normal part of life to a disorder requiring treatment. And who should pay for this? Insurance companies may cover necessary treatment but they will draw the line if normal human emotions become the subject of treatment. The more diseases we create the more health care will cost. Besides if someone really has extreme impairment as a result of bereavement that becomes Major Depression and gets treated right? Not exactly. 

Currently grief is excluded from the DSM-4 criteria for depression. The reasoning for this was that if everyone is likely to experience this sooner or later then it is not a mental illness. Just how much the death of a family member is expected to affect us is mostly a result of culture. Some cultures (mourn) for a year or more. The widow or widower wears black and is granted time to grieve their loss.

In western society we limit grief to 60 days. Many other acute life events are limited to 30 days. After that you are supposed to get back to work and living. Since the DSM guide to mental illnesses is published by the American Psychiatric Association it reflects American and western values. That may not be appropriate for people of other cultures regardless of where they live.   

Currently the loss of a close person is included in the DSM as V62.82 Bereavement. V codes normally are not covered by most insurance plans. At least two factions are working to change this.  

Those who are working on the new DSM-5 report that Complex grief is a disorder proposed by groups outside the APA which is being considered. Additionally people within the APA have suggested removing the exclusion for grief from the definition of Major Depressive Disorder. That would result in more people who have severe symptoms as a result of grief getting treatment under the Depression code. I suspect that in practice most clinicians after a while go ahead and give the diagnosis of depression, grief or no, after the client has had problems for a while.

But there is another problem with all this increasing of treatment for grieving people. A specialty is growing up of practitioners who say they specialize in “grief counseling.” The research has not been kind to some of those “Grief counselors.” Some grief counseling seems to do more harm than good. 

Personally I am all for helping people who need help but the idea that we might evolve a sub specialty of counselors who are doing harm not good worries me. Complex grief is not the only area where we have a risk of doing more harm than good. 

Some of the treatments for PTSD and other trauma counseling have the potential to make the victim relive the experience… rather than allowing them to heal. The repeated exposure to the trauma may retraumatize the client and (make) them worse.

Not everyone who experiences the loss of a loved one has symptoms we might call complex grief. People with a past history of Major Depression are more likely to become depressed again if someone close to them dies. So is this a new disorder “complex grief” or is this a reemergence of Major Depression? Add a second stressor like financial problems, divorce, alcoholism or addiction and the loss of a loved one is more likely to affect peoples functioning.

People with multiple losses are more at risk and so are people who have a loss in early life and then experience a loss again. If you lose a parent as a child, are you more likely to feel sad when someone else dies in your life? Does that make the second loss a mental illness?

Men and women differ in they way they show grief, so do people of different cultures. We would want to avoid creating a mental illness that only one sex or culture gets diagnosed with. But then we already have several that are more likely to be given to (women) than men.  Does that mean that there is a difference in the mental health of one sex or the other or only that we are defining the emotions of women and ways they express them as a mental illness.

Professionals don’t all agree on this.

So what do I think will happen? Wish my crystal ball was clearer. My guess is that we will not add complex grief as a new disorder. The APA looks poised to soften the criteria for Major Depression and let some people who are suffering from depression as a result of a traumatic loss get more help.

I also expect to see more peer and self-help groups with or without professional assistance.

So what do you think? 

Is complex different than normal grief? 

Should it be a separate diagnosed mental illness or is it a normal human emotion?

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This post was featured in “Best of Blog – May 2012” 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and co-occurring disorders see the "about the author page." about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, in its infancy, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. Thanks to all who read this blog.

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This post came out over a year ago. We know now that this writer's prediction did not prevail. He had said, "My guess is that we will not add complex grief as a new disorder." To the contrary, this very month, May, 2013, the new DSM comes out, the "DSM V," and it does indeed add "Complicated Grief" as a "disorder."  

Tommy and I, both trained in counseling psychology, and both grieving parents, are concerned with this added "diagnosis" as we know ~as child-loss parents- that what is being termed "Complicated Grief," and added as a diagnostic "disorder," is, in fact, the NORM for Child-Loss Grief and Trauma.  

Life-long grief is to be expected and adapted to, and should therefore not be coined as a "disorder," adding to the further pathologizing of Child-Loss Grievers that this culture already tends to do when we are struggling with our very normal grief...

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Pictures, thanks to ~The Compassionate Friends of Atlanta Siblings Group  

Article from CounselorsSoapbox.com

http://counselorssoapbox.com/2012/04/22/is-it-complex-grief-depression-or-bereavement/

Wednesday's Woe - The Temporariness of Grief's Reprieve… ~Tommy and Angie Prince

Wednesday's Woe

The Temporariness of Grief's Reprieve…

~Tommy and Angie Prince

It has been 6 3/4 years… What is any different in our grief over the loss of our beloved nineteen-year-old daughter?

~Wings of Hope-Living Forward

Not much really. Yes, we can function a little better. And yet, we are forever different.

And we do have breaks away from the heaviness of our grief, but there will never be any such thing as any end to our grief!


We can catch temporary breaks away from our grief, like Angie and I do when we keep our grand-daughter Ellie. But… the next day, you can count on it; the grief will come back with a vengeance. Our tears will start flowing before we even realize the particulars of what our grief is about… 

~Wings of Hope-Living Forward

Early on in our grief, when we found we had at least enough attention-span to watch a movie, we would experience a momentary break away from grief once the movie started, but as soon as the music came on signaling the end of the movie, we both would start weeping. We could not face going back into a reality where our child was not…

~Wings of Hope-Living Forward

The difference between now and then? 

~Out of the Ashes 

The reprieves can be a little longer now…

~grieving mothers ~Sharon Lee Hoover and ~Jill Compton

but still they are just temporary reprieves from our life-long grief ...










Graphic of swing, thanks to ~Angels at My Door