Saturday, March 26, 2011

The Older I Get the Less I Know: Understanding Grief

In my mother’s 90th year, give or take a few years, she told me that with each passing decade she realized how little she really knew. I understand exactly what she means.

What I know is very different than what I have come to believe. All that I know is that we must eat, drink fluids and breathe in order to live, and regardless of how well we do these three, we still die. Other than that, everything else is up for grabs.

So what’s prompted such a reflection, and why blog about it?

I spent a large part of this past week reading about the latest research on grief. This was prompted by reading an article in Scientific American entitled “The Neuroscience of True Grit.” The essence of this article is summed up as follows: “When the worst happens-a death in the family, a terrorist attack, an epidemic of virulent disease, paralyzing fear in the midst of battle-we experience a sense of profound shock and disorientation. Yet neuroscientists and psychologists who look back at the consequences of these horrific events have learned something surprising: most victims of tragedy soon begin to recover and ultimately emerge largely emotionally intact. Most of us demonstrated astonishing natural resilience to the worst that life throws our way.”

Reading how the brain is “programmed” to return to some sense of normalcy after a traumatic event, made sense to me. This prompted me to further explore the work of Dr. George Bonanno, a psychologist at Teachers College at Columbia University, who has dedicated his career to understanding resilience. I found a summary article he wrote that I thought was pretty accurate. We know that most bereaved people generally cope pretty well. Almost everybody hurts when a loved one dies but most bereaved people are able to keep on going; they work, and love, and move on and eventually the pain recedes. Second, most bereaved people are capable of joy and happiness, even in the midst of their most acute grief experiences. That's the way our emotional systems seem to have evolved. Constant pain would exhaust us. So we experience sadness and other emotions in short burst, and in between we get a bit of a break, maybe even a laugh or a smile. Third, not everyone grieves in the same way. Although most people cope reasonably well with the pain of loss, not everyone handles it the same way. Some confront the pain head on, mourning deeply and passionately and openly. Others are more demure. Some people prefer to keep active and distracted. Sometimes bereaved people behave in a manner that might seem a bit odd, but as long as they get by, it's usually ok. Fourth, anniversary reactions are real but they are usually not long-lasting. Thriving in the Face of Trauma

Along the way I uncovered a new book and a Times magazine article both written by Ruth Davis Konigsberg, a journalist, where she claimed to know “The Truth About Grief.”

After reading and re reading the article in Time, I found myself becoming increasingly frustrated by both what seems to be passed off as science, and generalizations being made that flies in the face of a lot of what I see and have experienced working with people who have/are dealing with major loss. This in turn made me start thinking of how little we truly know about most things. How research today is over turned years, or even months, from now.

With the first post on this blog, I think I made it clear that I would write about things that I thought were helpful for the people I work(ed) with. I also qualified that no matter how helpful I think something might be, if it doesn’t work for you, it doesn’t work for you. No more and no less. No need to say “I really tried but…” In short, I would never write an article with “the truth” in the title because truth is subjective-what I believe and someone else believes after having the same experience could, and often is, very different.

By way of this long introduction, and for what it’s worth, this is what I’ve come to understand about grief:
• The brain is amazing and strives to keep you centered. We are wired for resilience. Loss changes the brain, which ultimately changes how you think. That doesn’t have to be a negative.

• There are phases (not defined stages) of grief and mourning. If at any point someone figures they cant’ deal with the pain another minute, get help. While the “year of firsts,” can be hard, most people are in a much better frame of mind after six months. It doesn’t mean that they aren’t affected by the experience and that the course of their life isn’t altered by it. The way I think of this is from a story that a work colleague told me when I was in the throws of deep grief. She said when her father died, it was the first thought of the day for quite a while. Then it became a thought at some point during the day and had reached the point where she thought about it every three or four days. At the time she related that story, it was about a year from his death. For me, that’s been a very helpful gage of how I’m coping with a loss. Might be useful for you, might not be.

• People grieve in different ways. There is no “right” way. There is no uniform way across all cultures. The Japanese don’t even have a term for grief. Yet, all cultures have customs to deal with those who have died and those left behind. Unfortunately, there are not rituals surrounding other types of loss, such as being let go from a job you held for twenty years.

• Some deaths affect you more than others.

• What feels like, and may look like, extreme behavior is most likely a normal reaction to a very abnormal situation.

• Culture, gender, religious and spiritual beliefs, the relationship to the person, other issues of loss, age etc. etc. all impact how the death is perceived and how you deal with it. To think that research done on white American widows of 65 years of age and older, and extrapolate that to the universe of those in grief is just plain foolish.

• Customs very by culture and religion. While intended to help, they may not work for you. Being emphatic that someone needs to view the deceased, touch them or even attend a funeral is not helpful. People need to be allowed to do what they need to do and others need to keep their opinions to themselves. We are only authorities on ourselves not someone else.

• If you are with someone who is in the throws of grief, it doesn’t mean that it’s your grief or that you will experience something similar. Be present the best you can and listen. Some people like to hear stories of how others coped, survived and ultimately thrived from loss, others don’t want to hear them. Use your judgement.

• Ultimately, we all do our best in these situations and our best is more than good enough.

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