Why Does Grief Go Untreated When It Is So Destructive?

I have a hard time digesting the fact that in the DSM-5, Grief is not a treatable disorder unless and until it becomes complicated. We don’t come with handbooks that tell us how to grieve, when to start or even more importantly, when to begin to stop. Why is it so unfathomable then, that we can give ourselves permission to set a date to begin to heal from grief? Grief can cause an assortment of physical, mental, emotional and spiritual problems that can lead to an early death. Yes. You heard me right. Broken Heart Syndrome is real and is also called Stress-Induced Cardiomyopathy. I have this theory, that the physical manifestations of grief including heart attack, blood clots, fluctuating blood pressure as well as cardiomyopathy, can all cause emotional imbalances that lead to a weakened immune system due to the rise in the stress hormones that are being released, which also lead to intense mental pain that causes hopelessness and in come cases self-mutilation which leads right back up the ladder from mental, spiritual, and emotional pain right back to physical. Persistent efforts to ignore grief lead to denial and the effort to refocus the narrative leads to complicated grief which blocks reality so the body and mind cannot effectively integrate the person’s new reality. It’s a ferris wheel of denial and pain. Picture symptoms getting on and off while the pauses give the person some sense of relief so the denial factor grows. When in reality, what is happening is the stress on the body further increases and worsens the weakened immune system which prolongs ailments. What this may look like is if someone was a longterm caretaker and their loved one passed away their gout or arthritis may flare in the aftermath. As they grapple with the reality of having to go back to work or pay the longterm health care bills that had been piling up, they may discover that they are now ill themselves. But this does not have to happen. If there were a consensus on what this term meant, then others may possibly get funding for something so basic.

Giving oneself permission to grieve along with permission to choose a date when to begin to stop grieving and outlining steps to take to get there are necessary for a positive outcome. I will be publishing more in the days to come. Thank you.


The Rule of 3 in Grief

The days are divided into 3’s: Hard, harder and over it. Bed please.

Why can’t we nail Jell-O to a wall but we try three times anyway? The same reason we always try to blame ourselves for our loved one’s deaths…”If only …”

Why do we have to try doughnuts three times before we find one we like? The same reason we have to see three counselors before we find one we like. We are human and we have FOMO coupled with expectation.

Why does every partner expect that the magical third date must lead to sex? I’m thinking it just requires clean clothes.

Why are there so many stages to grief? It should be hard, harder and used to the unexpected waves. Martini please.

Survival: you can survive 3 minutes without air in cold water; 3 hours without shelter in a harsh environment (unless it is cold water); 3 days without water (as long as you are not in a harsh environment); 3 weeks without food (if you have water and shelter); but you cannot possibly survive the loss of a loved one for 3 seconds without immediately grieving.


You did it-you got through the Holidays. Now what?

We all knew it was coming. We stayed busy and avoided the mushy movies, the malls, the parties and the all-knowing-“you should get a hobby”-well-wishing relatives, right? So what is next? Spring. Ah, the time of year when the sweet smell of flowers and the kiss of warm air rushes by us, teasing young lovers out into the open where we must be a witness to loves rebirth (insert sound of phonograph needle scratching across a new record). There will be wedding invitations if we are lucky, parties to slim down for and the warmth of summer to look forward to. However, grief will not take a break so that it all can be easily enjoyed. Instead, we need to make a plan. Yes, a grief plan.

Grief plans are unique to every individual and are well thought out maps to navigating your new normal life. Eventually, you will not have to rely on them, but for now when the grief is still so raw that you are avoiding what you feel may be uncomfortable situations, then they can be a very useful lifeline. You can plan out your months, weeks or days and actually schedule your own grief time. Whether it’s alone time to pray or think about your loved one, or plan a monument or vacation to celebrate their memory, planning for grief is important. This is not to say that you won’t still have moments of gripping sadness or sleepless nights, you most certainly will. But if you plan for positivity, then the negativity will have less room in your schedule.

To begin, simply make a list of what you would like to accomplish, for example in workable two-three month increments. Make these your long-term goals and make sure they are actually doable and measurable so you can track your progress. Also make a list of things you still are uncomfortable doing, like going to parties, movies or even out to eat alone. Cross off the things you no longer care about and make what is left your short-term goals. Things you can easily accomplish in a week. Keep a journal and also jot down your feelings as you progress. Are you finding yourself happier? Sadder? More energized? This can help you realize what makes you the happiest so you can do them more often.

Keeping a journal is so important because our brains get muddled and it’s difficult to see how much progress we have made without one. They can be messy, hard to read, have scribbles and unconnected thoughts, or they can be precise with excellent penmanship (although I have never seen one that is)! The journal will become the roadmap of your soul’s journey. It will be freeing to get all that chatter out of your head and on to paper and so healing to look back and see just how strong you have become. Good luck.


Action Oriented Grieving: Putting how you feel into words can help you (1) connect your behaviors in that moment to your feelings, and (2) help you create a new action plan going forward.

This doesn’t mean that you’re trying to stop your grief. You are just channeling that restless energy into making positive improvements in your life, and journaling can be helpful to that important step in your growth. This wheel can help you put into words how you are feeling and whether a certain behavior brought those feelings to light. For instance, if you were out enjoying a few cocktails with friends and suddenly felt overwhelming sadness because seeing all the happy couples enjoying each other made you cry and you could not explain it to your friends, this wheel can help. If you find SAD in the center, you most likely are experiencing one or more of the middle feelings which brought you to one or more of the outer reasons. Journaling this will help you remember how this activity made you feel and in the future could serve as a reminder to you. It also helps to go back and read those entries to see your healing progress.

Helps you find the right words to describe what you are feeling
Feelings Wheel.com

Putting action-oriented grieving to work also may include harnessing that restless energy that we have from grief into making positive impacts for others and more positive improvements toward healing. Directing your energy by providing support to others who are grieving, or by creating a memorial for your loved one or even by advocating for a cause you believe in will inspire others and are all examples of action-oriented grieving.


Today I Saw a Ghost at a Funeral

I was sitting by myself in the lonely and cold room of the funeral home staring at my friend’s body surrounded by flowers. He looked good as corpses go, decked out in a fine suit with an Art Deco pin on the lapel. He had on a lot of make up, but then again, most do. The casket was glistening steel in a muted silver and they hadn’t bothered to drape the underside, so the criss-cross bars that supported him were exposed. There were a smattering of funeral floral arrangements, all beautiful and one just as fragrant as the next. There were two screens on the wall above him, playing a woman speaking and singing incessantly as the tape rolled over and over. She had a great voice, but it was a short video and the volume was too low to be heard in the back, where I finally moved to after an hour and a half of waiting for the service to begin. More people made their way in and as the waiting time became closer to two hours, some began to leave. The older age of those gathered made no argument for the rest of us to get back to the day at hand. As I looked around, I noticed a friend and he came and sat and said hello. He was shaking, sweating and smelled of tobacco. I saw that he came in earlier and left with two other guys and was just returning. As he started to speak, his voice was shaky and he was unable to speak in a clear sentence-as if his speech was forced, muted and choppy. His eyes were so dark and his hands were trembling. All he could muster was “I’m socially inept at the moment”. I asked why and he said he was just having trouble. Fresh out of rehab and back in town, he was contacting old customers like myself as he was starting a new job this evening. My body language must have said it all, if only he were sober enough to have read it. In his twenties with so much talent and a bright future ahead of him, he was making ill use of his idle hands and wide open schedule. He managed to awkwardly apply his black cloth face mask, half exposing his mouth and beard. After about 15 minutes, his body began twitching uncontrollably as he was either going into withdrawal or suffering from chorea. I weighed out my options of either giving him my business card which listed my specialty in counseling or just asking him about his sobriety. I did neither. After all, I am not his counselor and I have no business asking him about his choices. On the other hand, I do care that a young guy that I care about is absolutely not ok. It reminded me of some terrible choices that I made at his age. I remember that horrible feeling of not being able to speak when spoken to and wanting to sink into the floor. Today, I saw a ghost.


When Love Isn’t Enough

I recently attended a funeral and the stepmother wasn’t acknowledged at all by the deceased or her family in the service or the obituary. She had been married to the deceased girl’s father for 30 years and all of this came as quite a shock to the stepmother. She certainly counted her children as her grandchildren, gave and received cards and gifts from them and always attended every outing and family function. Over the years, the deceased woman’s mother who was originally married to her father, made it clear to the children that they were not to acknowledge the stepgrandmother, so they felt awkward at gatherings. This didn’t deter the stepgrandmother from loving them. After all, they were only children and didn’t deserve any of this.

When the stepdaughter became very ill, the stepmother and mother found themselves at her deathbed together along with the father. They were able to forget their differences and the stepmother thought that this was finally the breakthrough she needed in order to help the young family with their loss. The stepdaughter’s husband was so full of grief that he was losing the love of his life, he was bitter and angry and consequently took it out verbally on those nearby. This united the grieving parent trio even more. The children were also less wary about who to turn to for support at their time of great need.

After her passing, the husband was left with the children and his family to help him. A few days later, the obituary was placed in the local paper and the stepmother’s name was left out intentionally. It read, “she is survived by her parents” and listed her mother’s name and father’s name, as if they were still married to each other, along with other family and extended family member names. This included her half brothers whom she only saw a handful of times in her life. Her husband was furious when he read it and she could only cry. You see, she had known her stepdaughter since she was 9 years old. They had always told each other “I love you” and exchanged cards and messages on every holiday. She was always the first person that came to mind at Christmas and even at her wedding, the stepmother was asked to read a special passage and they shared a special day at the winery after presenting her with the tiara she wanted to be married in. The stepmother gave her three special baby showers and she was always made to feel that she was part of her family.

The stepdaughter’s husband said that he had orders from above (whatever that meant) and wrote it as he was told to. The father and the husband had breakfast and the husband apologized to the father and then called the stepmother to apologize. She said she wasn’t angry because after all, he had just lost the love of his life, his young wife. But inside she was so hurt.

The day of the wake, the stepmother being comfortable with the mother now, asked her husband to call her and offer her a ride since she was alone. The husband was on the phone and put the mother on speaker, so the stepmother could hear. She asked if the father had read the obituary and he said that he had, not mentioning the stepmother’s hurt feelings. The mother proudly stated that the husband asked for her input and that she had approved the obituary. The stepmother now knew that her name was intentionally left out because the former wife was still trying to get even with her husband for leaving her 39 years ago, and for marrying the stepmother 30 years ago.

I know this story is true, because I am the stepmother in this story. No matter how much you love someone, sometimes it isn’t enough in the end.


Persistent Complex Bereavement Disorder

If you have lost something or someone that meant something to you, you will grieve the loss. It’s ingrained in our DNA as living beings. It is the price we pay for love.

There is no getting around it. It’s a door you have to walk through in order to get to the other side. Some people claim that they never stop grieving, it just morphs into something softer like an old sweater that you know is unravelling but still feels familiar and is strangely comforting.

You fear that if you pull it out into the open too many times it may just fall apart and you’ll forget what it feels like, so you fold it up and test placing it on a shelf for a while until the feelings are so unbearable you walk around wearing an old sweater in the heat and people begin to stare. Family and friends stop calling because they don’t know how to help you and they feel embarrased and ashamed to admit it and this makes them feel powerless. This would be tragically sad if it werent so… ironic.

After about a year, if you still feel as if your head is in the clouds, and you’ve made robotic attempts at living, all the while still yearning for the deceased as though the loss were yesterday, you may be experiencing Persistent Complex Bereavement Disorder. It is defined in the Diagnostic and Statistical Manual of Mental Disorders fifth edition as continuing to experience sorrow and intense emotional pain; preoccupation with the deceased and the circumstances of their death on more days than not. It has been descibed as being emotionally numb, having difficluty with positive reminiscing about the loss with escessive avoidance of people, places and situations that may be a reminder and bring pain to you. Sometimes there may also be a desire to die in order to be with the deceased and feeling utterly alone in that process. Life may have no meaning any longer and trusting others to confide in is nonexistent. And if the breavement was due to tragic circumstances, such as murder or death by suicide, there may also be a preoccupation with the factors surrounding the loss.

Children also can suffer from the disorder. Unlike adults, children are usually more resilient when it comes to loss. After about six months (versus twelve in adults), they have usually accepted their life as it is as their new normal. Grieving in children will resurface at each holiday, birthday and anniversary, but will return to baseline and this should be expected into young adulthood. On the other hand, if after six months the child continues to express yearning in their play behavior and has marked difficulty accepting the finality of death, then they may also be experiencing the disorder. Younger children will avoid talking about their feelings regarding the deceased and older children may be preoccupied with them. The less the caregiving routine of children is disrupted, the better.

Increased and misdirected anger when someone speaks about the deceased, acting as if the deceased individual will be coming home, cooking meals for them or saving presents for them at holidays or auditory or visual hallucinations in adults may be present. This can occur at any age after 12 months of life. Grief responses are different, and usually occur at once after a loss. PCBD may be delayed months or in some cases years. Although this is rare, anyone experiencing these symptoms should get medical help immediately.

Pathologizing grief to some is unnecesary, however there are those that walk around in many, many shades of pain and are afraid to ask for help. Please don’t be. Death remains a mystery but to those of us left behind, it can be a great teacher if we learn to share in our grief. As much pain as you may be in right now while you are reading this, please know that there is someone else following right behind you and it may help them to know that you survived in spite of it.



Grieving Before the Loss

Life is not always easy and to watch someone we love suffer can make it unbearable. All too often the grieving process starts before the person who is ill is ready to make others feel better, or even face the end of the battle themselves. Tempers flare, feelings fly out of people’s mouths and tears flow uncontrollably. It stems from feeling helpless and being overwhelmingly sad at the same time. One might say that the entire world that they know has become tilted in an effort to minimize the burden of carrying around a heavy, invisible boulder known as grief.

Offering kindness in the face of such adversity seems like a cliche, but it actually has a healing effect that is contagious and can change the temperature of a room in an instant. Grief is messy business because we are human and there is no handbook of etiquette. But we have to remember to offer kindness to ourselves first and the rest will follow.

Venture into mindfulness at times when the feelings become unmanageable. This simply means to reground yourself through a form of meditation. Some people reconnect with their five senses: focus on one thing each that you can see, feel, taste, hear, and touch. Next, slow down your breathing by inhaling deeply through your nose for a count of four and slowly exhale through pursed lips for a count of six. Repeat. This process slows down your autonomic nervous system (your flight-or-fight and/or freeze response) and has a very calming effect on your brain and body.

Everyone grieves and there is no right or wrong way to do it. Take care of yourself first so that you can be there for others. Families all have dysfunctions and these tend to become illuminated at the most inopportune times, and especially at funerals when emotions are raw. Kindness is armor. Love yourself.


How do we mourn…let me count the ways.

It’s the thought that counts

First, it is important to distinguish between grief and mourning. Grief is the profound roller coaster of emotions that we feel after a loss. Mourning is how we express those feelings in order to honor those who we have lost. Depending on our culture, we may dress in black, cover all the mirrors in our home and/or not attend to superficial tasks for seven days. Sitting Shiva as it is called, provides a specific time for spiritual and emotional healing when mourners join together usually at home to honor the dead. After seven days, it is then acceptable to get on with “the business of living”. In some Christian cultures, wakes are held and can last for days. The body may be brought into the home for viewing and people gather to memorialize their loved one prior to buriel. In some cases, this is done in a funeral home or chapel and the family will gather there. In cases of green buriels, the body may be shrouded and placed outside, surrounded by the beauty of nature and wildflowers before family and friends gather with shovels to help with interment.

And even with all of the choices we have available to us, sometimes family members are rendered speechless as they are met with only an empty urn to say goodbye to, having either not been privy to their loved one’s final wishes, or sadder still, their loved one’s spouse who vindictively and intentionally withholds information-and the body’s whereabouts- from the rest of the family. Using this type of malicious, passive-aggressive behavior can be psychologically damaging and is morally reprehensible, but legal.

It happens more than people realize.

Then, there are those who do not consider the possible harm that shocking others with their final wishes may have. Take for instance a young mother who died by an overdose when she was nine months pregnant. The family had many choices in how to honor her and her child. They chose to embalm them both and placed the child in her outstretched arms as if she were about to gently toss him up in the air on a fun-filled day at the park. He was dressed like a toddler-not a newborn, complete with tennis shoes, tiny jeans and a plaid shirt. She was adorned in a cheerful dress, sunglasses and sandals laying on a red and white checkered tablecloth on top of faux grass with a picnic basket full of flowers nearby. There was no casket. The family explained that this was their vision of how she and her baby would enjoy the afterlife together.

Hence, in death, as in life, there are many ways to honor and memorialize our loved ones. If we fail to make these choices for ourselves, rest assured that someone else will have the final say in how we will be remembered. It is never too late to write down your final wishes and let someone know where to find this information-with the full knowledge that these wishes can and will change over time. As always, the best place to begin is with the end in mind.

Real tombstones. Courtesy Pinterest.


Why do we grieve?

Because we love. It is that simple. I have heard from clients that the deeper we love, the harder we grieve. This is quite possible. And if this is true, then it makes sense that the more traumatic the loss, the harder the grief process will be. Grief is not a condition or disorder. It is a natural response to a profound loss. And because of this, some say that counseling or therapy is not warranted. However, sometimes traumatic grief becomes more than we can handle alone and an intervention is required to get us back on track.

There are many online and in-person support groups for those who are grieving because talking to others who share an understanding of the process does help. Talking about those who are no longer with us and having a safe space to grieve openly and honestly helps to bridge a former life with a new one for those of us left behind.

But where can you go to talk about the details of a horrific traumatic loss? Here. Right here. I hope that you will share equally the stories of your losses and your triumphs. I hope that you may find others to comfort you along the way and find some peace along your journey.