Thursday's Therapy - "Breaking Bad" Grief Therapy ~Dr. Joanne Cacciatore alerts...

Thursday's Therapy

"Breaking Bad" 

Grief Therapy

~Dr. Joanne Cacciatore alerts...

Thursday, June 26, 2014

The Holy Longing is Yours: Caveat emptor

(massman: noun,  an average, typical, or ordinary man :  a prototype of the mass society especially when regarded as lacking individuality or social responsibility, as drawing his stereotyped ideas from the mass media, and as easily manipulated by economic, social, or cultural elites)

Every week, I have the privilege to hold a discussion about grief with colleagues Dr. Geoff Warburton & therapist Megan Devine, two dear friends who simply 'get it.'

Both have experienced grief from the inside during the course of their lives and have now devoted themselves to the practice of grief counseling.

We share a sentiment about grief in Western culture. That is, in general, grief is widely misunderstood, castigated, affronted, and bypassed in practice, theory, the media, and even in some spirituality.  Most recently, we discussed the spiritual bypass, and a more thorough triadic diatribe about this topic is forthcoming. I digress (as usual)...

Fast forward to today.

Another dear friend, a medical doctor and researcher in Canada working in refugee health (note: plenty of grief and trauma in this population), recently attended a conference in the U.S.  One of the days in this conference was devoted to "bereavement care".

She was so upset by what she'd heard that she abruptly exited two workshops that were intended to help grieving parents.

She sent me some of the materials to review and I shared her deep concerns. Actually, I was mystified and astonished.

Two clinicians who were presented posited "therapies" which were not only (less than) pseudo-science but more than that: They are potentially harmful to the bereaved.  Their suggested "interventions" may even further disenfranchise, stigmatize, and pathologize normal, albeit painful, traumatic grief.   Their strategies promoted the "unfeeling" and "unseeing"and even medicating of grief... precisely the opposite of what research in traumatic grief suggests as most efficacious, and it was some of the most 'unmindful' and experientially avoidant propaganda I have ever seen.

Experiential avoidance (that is the chronic turning away from or distracting of painful emotions/memories unconsciously), in fact, in the SCIENTIFIC literature is closely linked with substance abuse, physical illness, and other maladaptive behaviors and affect. 

Look, I get it.

Clinicians are not often researchers so they may or may not be able to discern the rigor of a study's outcomes. Many of them don't even have time to read the research and may not understand methodology.

So, herein lies the dilemma: Bad therapy happens. And bad therapy isn't just bad therapy- it's not like a bad haircut. These are people's lives. And not just any people. The most vulnerable population on earth.  Very, very dangerous, indeed.

So here is a rare offering of advice - maybe an invitation - for bereaved persons: caveat emptor.

Be careful with whom you share your grief.

Be careful with whom you share your grief.

Be careful with whom you share your grief.

And be wary of advice wielding, arrogant "clinicians" who think they know it all.

The clinicians who know best are the ones who admit they know nothing. The best therapists are the ones who admit their impotence in the face of such trauma and suffering. They are the ones who say, "There aren't words... I have no cure... And I will join you in the abyss..."

They are some duplicitous charlatans who are out to exploit. But there are also many well-intended who can harm you and me and us all. They often don't read or understand the research, they believe what others in positions of authority tell them without question, they may not be prone to dialectical thinking, and they often pretend to know the unknowable. Even if unwittingly, they end up preying on those who are desperate for any help, presenting themselves as the experts.

They are on the internet, on Facebook, at conferences, in clinical interactions, and in the grocery store.

Western culture, by its nature, promotes the use of nearly any strategy to bypass grief. Drugs, sex, alcohol, shopping, food, gambling, exercise, work, any distraction you can name. Even therapy.  But the sages knew what we seem to have forgotten in contemporary society: No 'intervention' and no interventionist can 'cure' your grief.  There is no panacea. You are not broken, you are broken hearted. And as Rabbi Mendel of Kotzk said 'there is no more whole heart than a broken heart.' 

You are not in need of repair. No alphabet soup intervention (ABC therapy, XYZ medication) and, certainly, no drug can assuage your grief.  The only way is through, and the only way through is with loving, nonjudgmental support, good self care and self compassion, and some other things demonstrated in the literature to be helpful in coping with, not eradicating, grief. And frankly, the source of many concerns about the prolongation of grief resides within our own social groups- others pressuring mourners to 'get over it,' 'move on', 'feel better.' Others who do not remember with us. Others who ostracize us and treat us as lepers. This kind of social reaction is not helpful, and actually is quite isolating and harmful for grievers. So let's focus on an intervention for a sick and intolerant culture that coerces us into believing we are entitled to happiness and comfort and immortality at all times and at all costs.

So if you need some extra support because you are feeling lonely, withdrawn, and confused, that help can come from those who are innate helpers from within your circle of friends/family/faith community and/or from those trained to help you to integrate your grief..., not push it away, decry, avoid, repress, or otherwise deflect it.  Surround yourself with others who have a "PhD" or "MD" or advance degree in common-sense and loving kindness.

Hell, I've seen animals give better 'therapy' than plenty of 'therapists.'

Again my unsolicited advice: Do not believe everything a so-called professional tells you. If it offends your soul, follow Whitman's advice and "dismiss" it.  Rather, trust the wisdom of your own grief. Get help if and when you need it from others who will embrace and uphold you and who understand what SCIENCE says about trauma, grief, and love. Yes, love.

Little in this conference's literature I read as it related to grief was based in science. And, nothing in any of the literature I read from this "conference" felt like love. And this saddens me beyond words.

Because in the end, grief is not a medical issue. Grief is not an issue to be solved or cured. Grief is an issue of the heart. 

Heed Goethe's harbinger: Beware the massman, the troubled guest on the dark earth.

~~~

Thank you to Dr. Joanne Cacciatore for her heartfelt words or warning to us so that we may protect our grief-torn hearts and souls as best we can in choosing wisely to whom we open our hearts.

Dr. Cacciatore's article:
http://drjoanne.blogspot.com/2014/06/the-holy-longing-is-yours-caveat-emptor.html

Tuesday's Trust - Oh, To Protect Our Child-Loss Heart!

Tuesday's Trust

Oh, To Protect Our Child-Loss Heart!

With grief my companion,

I sometimes question,

Will its roots overtake me

On this Child-loss journey?

Or will those who say they love...

Squelch my heart with their toxic "love"?

We take some precautions

Though some may think we're haughty ~

(They can't know what we're living

For they think our grief trivial…)

Grief is quite enough you see,

We cannot endure toxicity…!

So...

We have a protective membrane

We keep around our heart

To hold in love, keep out disdain

To soothe our Child-Loss heart.

Our heart was thrown in deepest pain

When once our child did part

From which we crawl a bit each day

By grieving from the heart.

We have a protective membrane

We keep around our heart

To hold in love, keep out disdain

To soothe our Child-Loss heart.

Since our heart's in deepest pain,

We each must become detective,

A sleuth to spot fake love's disdain

To ensure grief's heart, protected.

We have a protective membrane

We keep around our heart

To hold in love, keep out disdain

To soothe our Child-Loss heart.

So whether you are friend or foe,

There is one thing you need to know:

We've become experts of the heart;

If your heart is mean, you must go ~

Beloved though you are, we must part!

We have a protective membrane

We keep around our heart

To hold in love, keep out disdain

To soothe our Child-Loss heart.

*****

Trauma survivors have every right to want, desire and expect to feel connection, caring and comfort….

~psychotherapist, and trauma specialist, Kathleen Young, Psy.D.

*****

…I'd only just begun to discover how important relationships are to the healing process…. (T)he nature of a (trauma victim's) relationships--both before and after trauma--seemed to play a critical role in shaping their response to it. If safe, familiar and capable (people) were available to (the trauma victims), they tended to recover more easily, often showing no enduring negative effects of the traumatic event. We knew that the "trauma-buffering" effect of relationships had to be mediated, somehow, by the brain.

In a social species like ours… all… essential functions are deeply dependent upon the brain's capacity to form and maintain relationships…. That's why, as children, we come to associate the presence of people we know with safety and comfort; in safe and familiar settings our heart rates and blood pressure are lower, our stress response systems are quiet.

But throughout history, while some humans have been our best friends and kept us safe, others have been our worst enemies. The major predators of human beings are other human beings. Our stress-response systems, therefore, are closely interconnected with the systems that read and respond to human social cues. As a result we are very sensitive to expressions, gestures and the moods of others. As we shall see, we interpret threat and learn to handle stress by watching how those around us (behave). We even have special cells in our brains that fire, not when we move or express emotions, but when we see others do so. Human social life is built on this ability to "reflect" each other and respond to those reflections, with both positive and negative results….

Recognizing the power of relationships and relational cues is essential….

We learned that some of the most therapeutic experiences do not take place in "therapy," but in naturally occurring healthy relationships. The (trauma victims) who did best… were not those who experienced the least stress or those who participated most enthusiastically in talking with us (therapists). They were the ones who were (in) the healthiest and most loving worlds…. (W)hat works best is anything that increases the quality and number of relationships in the (trauma victim's) life.

Relationships matter: the currency for systemic change was trust, and trust comes through forming healthy… relationships. People, not programs, change people. The cooperation, respect and collaboration… gave hope (to) make a difference….

~Bruce D. Perry, M.D., Ph.D., the psychiatrist called in to head up a "rapid response" Trauma Assessment Team for the 21 children rescued from Waco by the FBI on February 28, 1993, as told in his book, The Boy Who Was Raised as a Dog… What Traumatized Children Can Teach Us About Loss, Love, and Healing

Picture - "Companion" by Fear_Through_the_Eyes on Tumblr via landscapelifescape: http://landscapelifescape.tumblr.com/post/12114930069/companion-by-fear-through-the-eyes

Poem - Oh, To Protect Our Child-Loss Heart! - Angie Bennett Prince - 11/7/2011

Thursday's Therapy - Self-Care in Child-Loss Grief: The Importance of Safety Amidst Trauma ~Tommy and Angie Prince ~with Judith Herman, M.D.

Thursday's Therapy

Self-Care in Child-Loss Grief:

The Importance of Safety Amidst Trauma

~Tommy and Angie Prince

~with Judith Herman, M.D.

I heard myself telling a fellow-therapist friend of mine this week how important it is in my child-loss grief to do a lot of "self-care." Then I proceeded to tell her the kinds of things I was trying to do to "care" for myself...

In Trauma and Recovery, Judith Herman talks about how important self-care is in dealing with trauma:

(Our) relationships with other people tend to oscillate between extremes as (we) attempt to establish a sense of safety. (We) may seek to surround ourselves with people at all times, or (we) may isolate (ourselves) completely.

In general, (we) should turn to others for support, but considerable care must be taken to ensure that (we) choose people whom we can trust.

Family members, ... and close friends may be of immeasurable help; they may also interfere with recovery or may themselves be dangerous.

Relatives or close friends who take on the task of participating in the survivor's safety system must expect to have their lives disrupted for a time.

{If you are going to enter our world, it's likely going to be very disruptive to your life. It is going to be uncomfortable, borderline unbearable; you can bet emotions are likely to flow if you are a "safe" person. Of course it is going to feel unbearable; it is well-understood to be the worst possible loss in the world. You cannot minister to a child-loss person from high atop your ivory-tower; you must be willing to climb down into his grief. And it will be painful, but it is human pain that can be comforted if only by being human, and being with him IN it.

Enter in only if you can be kind, compassionate, and accepting of the person where she is while loving her with a gentleness of understanding. You must always "know what you don't know" and let the griever herself tell you how painful her grief is to her. And NEVER, EVER be so arrogant as to think you can give her any kind of so-called "helpful" advice of how to "get over" such a life-long grief that has life-long repercussions of the most painful kind; such arrogance would be an affront to the bereaved, and you will quickly become a persona non grata to the griever from that point on.}

Underlying tensions in family relationships are frequently brought to the light under this sort of crisis. While intervention must focus on helping the survivor and her family to deal with the immediate trauma, sometimes the crisis forces a family to deal with issues that have previously been denied or ignored.

{Many family members refuse to get any such help, and therefore toxic family issues can go unresolved and can therefore interfere with our healing process over grieving our beloved child in the utmost safety needed. If you cannot work on your own issues, you will not have the credibility nor the courage to be with the griever in any kind of healing way.

The narcissism of certain friends or family members can no longer be tolerated. They are "takers" and want life to be all about them, and suddenly we MUST have life be all about us for us to survive.

Up until being in an emotionally vulnerable state, we could possibly tolerate these friends or family members even though we didn't like some of their traits. But now, when we ourselves are undergoing the traumatic loss of a child, and then we experience a direct "hit" from a narcissistic "taker," there is an immediate realization that this is a toxic person that we can no longer be around, and many times that our relationship with such toxic persons can never be the same again.

Energy needs to be expended in self -care and that includes constantly assessing and reassessing relationships for their level of safety or toxicity and relating accordingly. We are in survival mode; it is like being in intensive care emotionally, and therefore we must guard against, and ideally keep out, any toxic emotional "germs" of any kind. But we have to be our own "nursing staff" in developing boundaries and assertiveness to protect ourselves.

Some have compared it to the castles of days of old that were surrounded by a moat: when we assess a person is "safe," we can choose to lower the draw-bridge to let them across and be close to us; when we assess a person is "toxic," we can choose to pull the draw-bridge up and not allow accessibility of any sort as it is just too assaulting to our grief-torn hearts and souls.}

Picture: Thanks to FotoSearch

Judith Herman, M.D., Trauma and Recovery (1992), Associate Professor of Psychiatry at The Harvard Medical School and Director of Training at The Victim of Violence Program at Cambridge Hospital

Thursday's Therapy - "The first days of grief are not the worst" ~Anne Morrow Lindbergh

Thursday's Therapy

The first days of grief are not the worst

~Anne Morrow Lindbergh

Anne Morrow Lindbergh: The first days of grief are not the worst

Contrary to the general assumption, the first days of grief are not the worst. The immediate reaction is usually shock and numbing disbelief. One has undergone an amputation. After shock comes acute early grief which is a kind of "condensed presence" -- almost a form of possession. One still feels the lost limb down to the nerve endings. It is as if the intensity of grief fused the distance between you and the dead.

Or perhaps, in reality, part of one dies. Like Orpheus, one tries to follow the dead on the beginning of their journey. But one cannot, like Orpheus, go all the way, and after a long journey one comes back. If one is lucky, one is reborn. Some people die and are reborn many times in their lives. For others the ground is too barren and the time too short for rebirth. Part of the process is the growth of a new relationship with the dead, that "véritable ami mort*" Saint-Exupéry speaks of. Like all gestation, it is a slow dark wordless process. While it is taking place one is painfully vulnerable. One must guard and protect the new life growing within-- like a child.

One must grieve, and one must go through periods of numbness that are harder to bear than grief. One must refuse the easy escapes offered by habit and human tradition. The first and most common offerings of family and friends are always distractions ("Take her out"--"Get her away" --"Change the scene"--"Bring in people to cheer her up"--"Don't let her sit and mourn" [when it is mourning one needs]). On the other hand, there is the temptation to self-pity or

glorification of grief. "I will instruct my sorrows to be proud," Constance cries in a magnificent speech in Shakespeare's King John. Despite her words, there is not aristocracy of grief. Grief is a great leveler. There is no highroad out.

Courage is a first step, but simply to bear the blow bravely is not enough. Stoicism is courageous, but it is only a halfway house on the long road. It is a shield, permissible for a short time only. In the end, one has to discard shields and remain open and vulnerable. Otherwise, scar tissue will seal off the wound and no growth will follow. To grow, to be reborn, one must remain vulnerable-- open to love but also hideously open to the possibility of more suffering.

Contorted 3 Oil Painting graciously permitted by Crawfurd Adamson http://crawfurdadamson.com/

--Anne Morrow Lindbergh (1906-2001 ), Hour of Gold, Hour of Lead (1932). She and her husband, the famous aviator Charles Lindbergh, suffered the kidnapping and murder of their first child, not yet two, under the glare of worldwide publicity in 1932.

*true friend who is dead

http://www.consolatio.com/2005/05/the_first_days_.html

Thursday's Therapy - Writing and Grief - The Healing Power of the Pen ~by Alice J. Wisler

Thursday's Therapy

Writing and Grief

The Healing Power of the Pen

~by Alice J. Wisler

She? She lost her innocence,

And I? I lost my life.

She? She lost her life,

And I? I lost my innocence.

~Angie Bennett Prince 4/22/10

It's revealing that the titles of Fraser's and Want's books and Hendy's film all end in interrogation marks. The genre of grief memoir is by definition questioning: trying to come to terms with what happened and whether anything else might have been done.

~Mark Lawson, Writing a Way Through Grief

− Grief changes you. No matter how purposeful you are or become it impacts you in ways you can never work out. One of the reasons I started writing again was because I suddenly needed a voice to record the things that were happening, and people couldn't necessarily handle what I had to say.

Even I, a few years on, cannot fully appreciate the state of mind I was in when I wrote. It's just something that happens.

The brain has its bleeding and it must flow somewhere.

~Comment to Lawson's article by "disordered"

Spiritual equanimity is so finely worked that all wild, wounding, or awesome events fire the brain but briefly.

~Robert Dash, Notes from Madoo

My groaning has worn me out. At night my bed and pillow are soaked with tears.

~Psalm 6:6

Pain can be exhausting. Feelings of sorrow, depression, grief, and fear can eat away at us internally to the point that we feel our bodies will waste away. We lose strength. We forfeit any sense of balance and control over our emotions. We’re reduced to groaning, powerless, grief-stricken creatures.

Emotions are very fragile things. When you’re working through old hurts or new struggles, your emotions can help you deal with them in a healthy way. Stuffing them, pretending you don’t feel grief or fear, won’t help at all. In fact, it will hurt you in the long run.

~Peter Wallace, What the Psalmist Is Saying to You Today

Keep a journal. You will be surprised how much relief you will find through writing down your thoughts, questions, memories, fears, letters to your child, or anything else that comes to mind each day.

~Carol A. Ranney, Family Grief & Bereavement Examiner

*****

Often our child-loss grief, even as complicated and traumatic as it may be, is not always grief that needs to go through therapy, especially if that therapist is not extremely understanding of grief, even more especially if that therapist is not seasoned, with a few tragedies of his or her own under their belt.

As you read the following quote from a study of grievers (some of whom had bad experiences in going through therapy with their grief), you will see why I as a psychotherapist am somewhat protective of my fellow child-loss grievers. This dynamic that exists of the possibility that therapy, if poorly done, can also add to our grief also prompts me to find self-help ways that we can utilize to better process our grief on our own. Today's article is one of those self-help ways to enable our grief to flow out in as healthy a way as possible. As I have said to my clients,

Grief cannot be cured, but it does need to flow, and we CAN receive comfort in the process of our grieving. There is a lot to be said for that!

~Angie

...(D)iagnostic decisions ought to be conservative in the circumstances of bereavement to avoid interference in a normal human process and iatrogenic complications with the associated introduction of professional interventions and their accompanying side effects. [Belitsky & Jacobs, 1986, p. 280]

~from Grief Counseling and Grief Therapy by J. William Worden

*****

Writing through the heartache of losing a child is some of the best therapy I have found on this journey.

~Alice J. Wisler

*****

The Healing Power of the Pen

~by Alice J. Wisler

(Grieving Mother and Writing Workshop Leader)

The first year after a death of a child is like having the (worst) noise possible running through your head each day and night. There is no way to turn the horrendous sounds off because there is no off button.

I wrote through that noise. I wrote from the heavy bag of emotions bereaved parents must carry—anger, guilt, sorrow and confusion, all the "what ifs" and "how comes" and "whys."

I wrote of longing for a blond-haired boy with blue eyes (whose) laughter brightened hospital rooms. A quiet spot under weeping willows at a local park is where I carried my pen, journal and pain. As I wrote over the course of many months, I was, although I didn’t realize it at the time, providing therapy for myself.

Some days when the weather did not permit a trip to the park and my body and mind harbored excruciating pain, I shut myself in a room, away from my other children and husband. I’d grab my journal and let the experiences of the day and my feelings freely emerge onto each white page. Grammar didn’t matter, penmanship went out the window. These aren’t a concern when you are writing to survive.

Writing the heartache, complete and honest, is a way of healing.

Our cry is, "Help me with this pain!"

We find ourselves lamenting as King David did in Psalm 13:2, "How long must I wrestle with my thoughts and every day have sorrow in my heart?"

David wrote many of his psalms starting with anger and agony and gradually, ending with hope.

Writing can do that for us. We enter into our devastation, get a good grip on what our struggles are and something about seeing them on paper causes us to realize the pain is not only within us anymore. It is shared, even if only on a sheet of notebook paper. It is documented and the more we write, the better we are able to understand and deal with our intense sorrow.

Some people think only the creative types write, when in reality, writing through the pain is available to anyone who has suffered the loss of a child. "I don’t have time," many say. "What will I write?" others wonder. The blank page scares some because they think they have to fill it with something profound.

But just writing a memory of your child or a few lines about how you felt after he died is a notable start. If we think of writing as a private endeavor and an effective tool, not a paper to be graded by a high school English teacher, we will conquer many of the doubts about our ability. In time, we will see that writing helps us become better in tune with our feelings and thoughts. It clarifies our lives and gives us understanding.

Other reasons to take the time to write are:

• To experience personal growth.

• To leave a legacy or a keepsake so that there will be recordings of what and who our child was.

• To demonstrate a way of cherishing our child.

• To feel a connection to our child as we remember the things we shared here on earth.

We also are honoring our grief, our pain and what has happened to us. We are validating its existence. As studies have shown, writing is healthy for our minds and bodies.

Professor James Pennebaker claims that writing actually helps the physical body when the writer is able to open up, by sharing deep feelings on paper over a period of time. In his study, half a group of students at Southern Methodist University in Dallas, Texas, wrote their heartfelt thoughts and feelings about a stressful event from their lives; the other half wrote about superficial topics. Each group wrote for twenty minutes a day, for four consecutive days.

Before writing and immediately after writing, blood pressure and heart rates were tested and a galvanic skin response was done. Six weeks later, the students had their blood tested again.

The group that had written about trivial topics showed no sign of changes. But the group that had poured their pain onto paper, claimed writing had actually calmed them. Their skin was drier after writing and both heart rate and blood pressure had decreased. Their blood work even showed an increase in lymphocytes, the white blood cells that work to keep the immune system healthy.

Writing through the heartache of losing a child is some of the best therapy I have found on this journey.

I didn’t know how helpful it was. I just knew I needed to organize any thoughts and get them out on paper. Now, four years since my four-year-old son Daniel’s death, I see that when all the evidence is presented, there is no reason not to write. It causes dim skies to light up when not only the pain, but also the love and cherished memories, are recorded.

~ Alice J. Wisler

(Published in the Durham Herald-Sun in April, 2002)

Picture: http://bit.ly/d2oVtT

Poem - Aftermath - Angie B. Prince - 4/22/10

Lawson: http://bit.ly/d7W0BY

Commenter to Lawson: http://bit.ly/9mVXPg

Alice J. Wisler's blog: http://www.writingtheheartache.blogspot.com/

Wisler's article: http://bit.ly/avtKUb