Lessons in grief

Working with bereaved clients has taught me that a deeply enduring and difficult aspect of grief, is the complicated impact it has on time.  Most of us take time for granted. But in loss what time is and how it is experienced shifts disturbingly.

Not only has the bereaved lost a most significant and important person in their life whom they miss terribly but they have also lost their sense of how to be, their permit to be safe and fulfilled in time and their freedom to live out their happy days.

With the death of a loved one comes the disappearance of psychologically linear time.  Time feels weird, lost, disorientating, dislocating, confusing and fluid. People in grief find themselves in a seemingly stuck repetitive loop going over again and again what happened, how it happened. And longingly catching themselves remembering how they used to be when life was uncomplicated and everything was about having a decent enough time. The absurdity of what people say albeit in a well intended way, strikes hard.

“Oh time heals”  “life goes on” “you’ll get over it in time” “you’ll meet someone new in time”.  What a societal blindspot we have. The psychiatric and psychological professions have determined what is Normal Grief, what is Major Depression and what is Delayed or Complicated Grief and the timeframes allocated for each seem off. As a society we don’t have compassionate leave laws – how much time you have off depends on your employer and your GP – and we don’t discuss or help or prepare children to cope with bereavement when thousands and thousands of children across the UK will be impacted by loss. How strange. It strikes me that we as a society are heavily involved in pretending that life is always good. That in 2 years max everybody should be over their losses. Because we tell ourselves time heals.

Time doesn’t heal. People heal themselves if they learn how to exist meaningfully in time again. But this is hard and a lot of people get stuck, lost and frightened.

I feel that one of my jobs with grieving families is to help them step into time. Think about what matters. Think about how they matter. This is by no means easy. In a lot of cases, it is frightening, painful, enraging and totally exhausting. How can they give themselves permission to have time, to enjoy time, to make something happy and joyful of their time when their loved one doesn’t have this.

There is however a choice to be made. Bereaved people have not died. They still have life and with that comes the freedom to choose how to give time meaning or they can turn away, and just count minutes and hours. But what’s the point to that?

Learning to appreciate, nurture and take care of time is a healing step. To pay attention to that which nurtures purpose, nourishes self worth and builds meaning is a key aspect of grief work.

Choosing life. Appreciating that time won’t always be available and the choice to choose well is there.

 

World Mental Health Day – Recovery from trauma is about adaptation

It’s World Mental Health Day today and it is important to me as a psychologist, mother, wife, daughter, sister and friend to contribute to the debates about ending the stigma surrounding Mental Health and share some thoughts and guidance on how to cope with trauma. I am reading an excellent book at the moment by the wonderful Edith Eger. It’s called “The Choice” and I love it.  In it she advises that when we don’t allow ourselves to process and grieve our losses, our wounds and our disappointments the traumatic experiences of the past become like a prison and we keep reliving them. It is a psychological prison which locks us up in fear, anxiety, feelings of helplessness, panic, anger and frustration.

When a traumatic event impacts us we don’t have to choose to remain in a state of victimhood. There is nothing wrong with being a victim. What I mean is that there is a difference between victimisation (what others or circumstances do to us) and victimhood (which is about choosing to remain imprisoned by this event). I do appreciate that when you are thrown into this ontologically awake state of being in terror, it is really not something that feels like a choice. When I say choice, I mean it is an existential choice to invest your psychological energy into looking after you. Reflecting on what it is like for you to be you, trusting in the life processes and allowing yourself to heal. In my view taking an anxiolytic drug, or antidepressant drug won’t heal your pain. It will numb it. I am not against meds. They certainly help and can get people through the day. It is however, the reflective process – allowing yourself to trust that it is ok to look inwards and pay attention to your lived experience that is healing. We are not objects. We are beings and when a traumatic event happens we experience it in our core, through our beingness. Avoiding it makes little sense and healing comes from exercising the freedom to choose meaning. As Viktor Frankl said in “Man’s search for meaning” human beings have the capacity to face adversity and despair in a dignified and meaningful way.

Having said all that I do want to state that I do appreciate navigating trauma is tough and everybody experiences it differently. There is no right way to feel after a traumatic event. It’s personal. It’s unique to the circumstances of your life and what it’s actually like to have been you. The medicalisation of PTSD and human suffering has led to a pathologizing of what to me seems like an inevitable part of living. Is it possible to go through life without experiencing pain, loss, fear and some kind of trauma and mental anguish? I don’t think so.

What is important is the degree to which we allow ourselves to embrace our experience of the past.  Horrific, traumatic events happen but we don’t have to be imprisoned by them. We have a choice to face it, to share it, to process the emotional pain of it, to have it witnessed by others, to make sense of what now, to nourish our sense of who we are and how we matter. Everybody has the potential to adapt to traumatic life events. I am not suggesting this is easy. A lot of people need some guided support. But counselling does help with this.

A lot of people I work with in my practice, experience trauma as a devastating experience which rips their sense of who they are apart. They describe being caught up in paralysing fear. Anxious that life will never feel safe and normal again. Living with an impending or immediate sense of terror. It’s exhausting and invisible.

It’s important to remember that an unexpected, sudden, untimely and utterly devastating traumatic event is an experience that has a profound effect on the whole of your being, affecting how you think, feel about life, and how you continue to be in the face of such an event. Traumatised people find themselves going through a deep personal change that taps into all dimensions of their being.

When a traumatic event happens the first thing to happen is the embodied reaction. The physical dimension of trauma evokes a powerful bodily reaction which is completely normal. The body reacts by throwing the traumatised person into a state of arresting and paralysing shock, characterised by an intense feeling of disbelief and general numbness. Often people traumatized describe shaking, trembling, feeling numb, vomiting, crying uncontrollably, screaming, sitting stunned, silent, not feeling anything for ages, not crying but feeling a paralysing shock. All embodied reactions to trauma are normal.

The mind experiences a cognitive arrest, where the person traumatised does not feel that he/she knows how to be, what to say, what to think, and how to make sense of the new state of life. The overwhelming shock at the reality of the loss is imbued with a disorientating sense of being empty, blank and feeling alienated.

Many people suffering such a trauma, feel frightened by the intensity of their embodied response and get stuck in modes which are about pushing the anxiety of such pain away and down.

This doesn’t help. It builds and eventually pours out in other psychological disturbance. We are obsessed at the moment about productive recovery. Healing from trauma is about learning to integrate the experiences of the past into a coherent narrative about life, about our sense of self and about the future. Becoming engaged in meaningful relationships with others and nourishing our relationship with ourself is key. Finding a meaningful life project also is an excellent buffer.

If you are navigating such trauma – take pause, stock and get talking with someone who is prepared to listen. It’s vital you don’t expect yourself to go through this alone. If you need professional help invest in it. It is an investment into your life, your self. You matter.

To find a Counsellor, Psychologist, Psychotherapist take a look at the following websites:

http://www.counselling-directory.org.uk

http://www.bacp.co.uk

http://www.bps.org.uk

http://www.existentialanalysis.org.uk

http://www.psychotherapy.org.uk

Depression? She wont talk about it! What can I do?

I was recently asked by a friend about what she could do as her best friend, who suffers with depression, just doesn’t want to talk about it.  This is tough and in my experience often the case. People living with Depression (especially if it is severe) do not want to open up and reveal what it’s like for them.  They feel so exhausted, dark, fed up, hopeless and isolated that they really are frightened of the intensity of what they feel and where it may lead. It’s terrifying to live with depression and many fantastic campaigns are encouraging people to talk. And in principle I am in full support. But we must remember that getting a conversation started like that won’t be easy, or acceptable to the other. In this blog I hope to share some ideas of how to cope with such a situation.

Key to starting a conversation with someone who doesn’t want to talk is to acknowledge that you understand they don’t want to talk. That you ‘re not interested in burdening them with having to explain themselves and their feelings and thoughts to you. You are interested in understanding and empathising with what they feel, not why they feel it.

You can accept their way of being in an open, non judgemental and empathic way so that they can experience you as someone who cares for them, for whom they matter. This may help with their feeling of alienation and fear.

If they don’t want to talk about it, it is probably because they feel there is no hope and no point in talking about. Spend some time with them, in silence, letting them know you unconditionally love them, accept them in their choice to feel silent.

You could let them know that you care about them, that you will listen without judgement, that you are accepting that they may feel alone but that they are not. You are here.

Just one chat is not going to be enough. You may need to reiterate this again and again until they are ready to hear it. It takes time and remember you ‘re being an amazing friend.

You could ask them if they would be interested in a walk with you outside either in the park, or by a beach, or in the woods..whatever is near and convenient for you both. You could just be together in silence, listening to birds, shuffling leaves about, wading through mud, looking at the sky. Sing a tune? Nature walks do wonders for those struggling with depression. There is something meaningful about the timelessness and natural beauty of nature and being.

Do they have a bit of music which would mean something to them? Play it.

Are they into art in some way? Would they draw you a painting or a drawing which depicts their journey in life? Could you do the same?

Do they like to write? You could write together. Each sharing your stories of what it’s like to live.

Do they like planting and gardening? You could invite them to join you in some gardening? Watching a garden grown, planting seeds is therapeutic, connects us with the wonder of being and grounds in life’s simple purposes. They may appreciate the opportunity to throw themselves into an experience like that, rather than having to delve into their feelings.

Do they bake? Could you get involved in baking something together? There is something healing about making yummy, tasty food. Another experience to throw themselves into.

If none of this seems relevant you could ask something like:

“What it s like for you to be you?”

We are obsessed with explanations, and answers. Forget about it. Focus on what they are saying. Not why they are saying. If you start asking why you saying that? Why you feeling that? Then they:

(a) have to explain to you, which becomes about you and the intention here is to make it all about them

(b) have to defend themselves, because in most cases you may feel they ought to feel differently which again makes it about you, rather than them.

Often people handling depression have had all sorts of treatments, therapies to correct their thinking and adapt their behaviours and are still alone and in a dark place. In my experience silent internalised rage becomes their norm and destructive thoughts and behaviours happen.

You could help them find a therapist who is willing to listen rather than to fix and correct. CBT is not a panacea and humanistic oriented therapies do help. But really the only deciding factor in therapy is the quality of the relationship the therapist can forge with the client. So their orientation and technique is much less relevant. So you could look at the counselling directory (www.counselling-directory.org.uk) in your local area and help them find a therapist they feel they can trust and who will help them heal the traumas (often hidden from their consciousness) of their history and of their here and now.

I hope you have found something useful in my blog. I’d love to hear from you if you want to share further ideas and thoughts with me.

 

Thriving through trauma #mental health

It’s difficult to know how to handle the daily reminder that horrific, traumatic events happen across the globe every day. The older I get the more connected I feel with life’s unpredictability. In some ways all of us are always living with uncertainty, but it seems that political unrest, regular terror attacks and increasing mental health distress is really bringing this uncertainty to the forefront of my mind.

As a Psychologist working in Grief and Trauma, I am always impressed with the inner strength my clients find to rise again when floored by life.  The therapeutic relationship and encounter helps with that, but what I am left with is a humbling sense that human beings – with a little bit of guidance and support – can deepen their inner resilience and make life meaningful and purposeful in the face of traumatic life events.

In the spirit of sharing a fantastic tool kit and to spread knowledge, I am delighted to recommend this book by Sian Williams, to which I contributed a little. My bit offers a psychological understanding of how grief impacts us. It’s rare to find a book about trauma which is both accessible and informative. Sian’s easy accessible style and her refreshing candour make this a good read. I would recommend it to anyone facing periods of uncertainty. You are not alone!

https://www.waterstones.com/book/rise/sian-williams/9781474602709

 

What happens when sudden grief strikes?

There’s too much to say on this matter but I’d like to bring your attention to this. When sudden death happens your normal way of being in the world is shattered. The experience of actually existing, being in the world, feels profoundly and undeniably changed and it is completely normal to feel that nothing makes much sense anymore.

The illusion of safety, of some kind of order, a sense of being special is gone and it is very usual to feel confused, panicky and frightened for the safety of those you care about and for yourself and deeply disorientated in your sense of who you are and how you are.

Traumatically bereaved people often describe living with the unpredictability of death and this is not only frightening but exhausting and alienating.

A participant in a study of mine reflecting on the murder of her best friend said: “It absolutely doesn’t make sense… Absurd… It feels like it is the end of the world… It was just this horrible feeling that if this is really true, nothing will be the same again. Everything will change.”

If you are suffering with the impact of sudden and traumatic grief don’t expect yourself to go through it alone. Get in touch with someone who can listen. Being heard, understood, witnessed in your despair is so meaningful and will help you. Get in touch with someone who can help.

It is my experience that healing from the impact from a traumatic loss does emerge in time if

(a) You are kind to yourself

(b) You reflect on what and who matters to you and you hold this in mind when navigating life

(c) You give yourself permission to engage with life, meaningfully and hopefully

I have worked therapeutically with a many clients who suffer from the long term impact of such a loss and present in therapy with Panic Attacks, Anxiety Disorders and Depressive symptoms. The starting point is to allow them to be heard, understood and cared for in an unconditionally accepting way, non judgementally. Grief and trauma responses are real and the lived experience of this matters.