Thursday, August 23, 2012

Resurrecting Hope: Journeying Through Complicated Mourning

The Swan

This laboring of ours with all that remains undone, 
as if still bound to it, 
is like the lumbering gait of the swan. 

And then our dying—releasing ourselves 
from the very ground on which we stood— 
is like the way he hesitantly lowers himself 

into the water. It gently receives him, 
and, gladly yielding, flows back beneath him, 
as wave follows wave, 
while he, now wholly serene and sure, 
with regal composure, 
allows himself to glide.
                                                                                      Rainer Maria Rilke

WATCHING HOPE DIE

Last week I wrote about a colleague who has since become a dear friend of mine and her struggle with loss and grief.  Her son, an addict in recovery for six months, relapsed and overdosed one morning even as his mother was praying for him, feeling a deep sense of peace about his well-being. Here is the rest of her story. Please bear with me- it is a little longer my usual post but I invite you to read it, especially if you or someone you love has gone through a particularly tough loss.

For a long time there were days when the best she could do was to get out of bed.  She did not eat on those days.  If the phone rang it went unanswered.  Household chores were left undone. 
On his days off, her husband retreated to the garage where he sat for long hours staring at the car he had worked on with his son.
Photo Credit: Mark Grace

She was inevitably drawn to her son’s bed room.  She would lay on his bed with one of his favorite shirts crumpled in her arms.  “No one told me to do this. In fact, I was afraid to tell anyone about it, because I felt ashamed.  I would hold his shirt for a long time, breathing in his scent.  It was a like a little ritual that kept me anchored and caused me agony at the same time.”

You can imagine the tremendous odds my friend was facing as she tried to make sense of her experience.  Sudden unexpected loss is one powerful cause of a phenomenon known as complicated mourning.  For some reason many of us tend to have skewed ideas about grief in general, often expecting the griever to “get over” their grief in an unrealistically short period of time. Aubrey Smith has listed some of unhelpful things we Christians do and say to one another during times when we are suffering.  If you have a friend or loved one who is going through a difficult time, especially if they have endured a complicated loss in their lives, I’d recommend that you read her essay, to be found here.

In addition to the helpful alternatives Aubrey suggests, I want to add a few comments, based on my experiences in studying complicated mourning and working with people going through particularly tough losses.

  • There are no “stages of grief.” Katherine Kubler-Ross’ altogether wonderful book never outlined grief process or stages of grief. A closer examination of her classic text will show that she described five case studies involving five different people. She did not document a “grief process.” Many well intentioned people over the years have said to me, “We just need to get mom out of her anger stage so that she can move on in her grief.” Says who? Not Kubler Ross. Approaching your own or someone else’s grief as though it were a problem to be solved by “moving people on to the next stage” is almost always guaranteed to prolong the grief experience, not shorten it.
  • There is no time limit for grief. Twelve to twenty-four months is the time limit that is usually quoted when referring to so-called “normal” grief. Stop and think about that for a moment. First of all twelve to twenty-four months is about as imprecise an educated guess as you can get, It is NOT a scientific prediction. Of course the longer one’s grief interferes with life, the more friends and family should pay attention, but putting a stop watch on someone’s grief invariably makes them feel crazier and more ashamed of their experience, thereby adding to the complications of mourning.
  • No one gets over grief. Give a Westerner five “stages” and make the last one “acceptance” and you are guaranteed to produce, as we have in our society, a boatload of helpers whose single-minded goal is rush the mourner to stage five as quickly as possible. What I routinely tell people who are experiencing the agony of loss is this: “Your feelings are caused by two very easily identifiable factors. The first is that you are a human being. God made you to have feelings, not to deny them. The second is that the intensity of the pain you are experiencing is a sign of the depth to which you were committed to your dead loved one.” 
  • In other words, pain and sorrow are symptoms of humanity and love, and not of abnormality and weakness. No one likes to hear this. Most of us want it to be over as soon as possible. But so many of us who have had agonizing losses also will be the first to say that we do not want to be “cured” of our sorrow. The experience that Kubler-Ross identified as “acceptance” needs to be further described. Acceptance of what? Very rarely is it acceptance of the reality of the loss. Most often it is acceptance of the emotions that come with having lost someone or something intensely important.

BUT WHAT CAN I DO?

  1. Mourner: Get competent help in dealing with complicated loss. Don’t try to go it alone.
  2. Caregiver:  get informed and competent support. For yourself. You’ll need it to provide the kind of care you want to give. 
  3. Mourner: Understand that there is a rhythm to healing. Don’t force yourself to stay face to face with your loss on an uninterrupted basis. Go into it and then get away from it. Both poles of this rhythm are necessary. Friends or loved ones can gently, sometimes insistently help the griever to take a break. And sometimes you need to leave them alone and take a break yourself.
  4. Mourner: Stay away from people who try to cure you, cannot listen to your experiences, thoughts and feelings, who make judgmental statements about you, or who leave you exhausted from being around them.  Consider it the one best thing you can do for yourself to stay away from people who cannot give you what you need.  
  5. Caregiver:  Don't try to reason people out of their feelings. Someone once said that a perspective that is rooted in an emotional experience cannot be changed by rational arguments. Talking people out of their grief is an extraordinary waste of time, and sometimes can be damaging, especially for children.   
  6. Caregiver:  On the other hand, reality checks are a good thing. People in complicated grief sometimes need to be gently reminded of realities of daily living and the realities of the past.  Saying something like, "You know, I just don't agree with that. I know that uncle Albert loved you deeply," is just what is called for.  However, the longer we talk after making such a basic, self-responsible statement, the more likely it is that a powerful point will be lost in the griever's reaction of anger, shame, or self-blame. 
  7. Caregiver: It is not your job to heal the mourner.  If it appears to you that you have accomplished that feat, then head for the nearest professional so that you can carefully talk through the experience with them.  Only God heals.  Your job is to be with the mourner and to bring nearer the possibility that God will do for them what they cannot (and you cannot) do for themselves.Your relationship with your grieving loved one should never substitute for their relationship with God.  
  8. Mourner or Caregiver: Love yourself or your grieving friend pragmatically and in small, regular doses.  Not the cosmetic, clear-eyed, neatly put together self, but the self whose eyes are swollen from crying, who is still in her bathrobe at two in the afternoon, the self that is still irrationally expecting to see your loved one. Practice patient, persistent encouragement.
  9. Mourner or Caregiver: Be patient with strange experiences, intrusive thoughts, uncharacteristic desires or puzzling reactions.  Grief is complicated precisely because elements of our relationship to our dead loved one were not uniformly joyful or healthy.  Such experiences leave unfinished business. Mourner, you are not crazy. You are a normal person going through incredibly stressful circumstances. If you were in the middle of a hurricane, you would not expect life to bring you so-called normal experiences.  Don't expect that now.  
  10. Mourner: Let God love you by letting God hear your anger, your anguish, your desperation and your accusations. Read the Psalms if you don’t believe those experiences are biblical.

DOES IT EVER GET BETTER?

Wisdom & Hope
Photo Credit: Mark Grace
A couple of years, give or take many months after we began meeting together, my friend told me about an experience she had while driving to work.  She was still making the same commute from home to work that she had been making on that horrible morning.  “I can’t explain what happened.  The car was filled with his scent. I felt his presence, as though he were sitting there in the car with me.  He whispered in my ear, ‘Mom, I am okay.  I am really okay.  Don’t worry.”     

Her grief "process" was far from over.  But that experience represented a turning point in her sorrow and suffering. She began to find her way out of the pit of disorientation and despair, out of simply putting one foot in front of the other and began to wake up to new life and new hope.

My friend did not come to that experience because of great advice that I gave her.  She came to it because I insisted on being with her, praying for her, and honoring her journey and her ability to get the answers she needed from God for herself. And while her grief was not “cured,” she received something much more powerful—comfort from the God of all comfort.

What have I missed in this essay?  What has your experience been, either as a caregiver or someone who has experienced complicated mourning?  Leave a comment and help us all learn.

Blessings,
Mark




Photo Credit: www.crosscards.com

13 comments:

  1. I just wrote a fifteen minute post to you on that article on Corridos. Problem, you can tell I'm not a blogger, it didnt post then when I trie dto get back to it to cut and paste it to email it was wiped clean!

    So since my brilliance off to the dead zone of cyberspace the main points I made were:

    A) the article hits grief on complicate dloss right on... there are no stages there is only an enveloping cloud of all those that overwhelm and suffocate the grieving...

    B) It takes years and years and then one day I was able to realize earlier this year that I have no parents and I am okay again and alive again to be happy.

    C) Each person needs to allow themself their anger otherwise if they do not get okay with being angry then those emotions will never dissipate

    D) Much as some folk mock me for seeing The Dark Knight Rises 9 times and counting it is the single best onscreen depiction of complicated grief, loss, understanding oneself in grief and healing evenutally to return to living again. The trilogy as a whole even more so because you see the character's journey from before, during and after the death of his parents and how that shaped him. I would love to elaborate on this more with you some day over coffee or lunch at youor convenience.

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    1. Thanks, JP. I related pretty deeply to what you are saying. I kept going back to see "Aliens" over and over again for much the same reason-- to see the monster killed in the end . . .

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  2. This is an important article that impacts our approach to not only those who have personal complicated grief or mourning, but communal complicated mourning as well (as a result of natural or human caused disasters). My comments address not so much what is missed as what may be emphasized:

    1. Care-giver or Mourner - there is healing help in appropriate, welcomed touch (holding hand, hug, hand on the back, etc.) While showing care, it also goes a long a way in providing a sense of connection and anchor to reality. (I was with a mother in the Emergency room whose 2mth old baby was undergoing cpr from possible drowning. All mother wanted to do was hold my hand - tightly).
    2. Care-giver or Mourner - don't discount as illegitimate the silent grief, especially of men, just because no tears are flowing. While expressing that tears are ok, it is also ok to grieve with talking or silence or tasks. Honor the mode and pace of grief, abide with them.
    2. Care-giver or Mourner - feelings of anger or guilt or denial or acceptance, etc. are often felt simultaneously and or recycled.

    Thanks, Mark, for sharing.

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  3. Thank you for contributing! You are so right about the need for touch, silent grief and the "everything all at once" nature of emotional experience.

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  4. Touching!

    I come to this blog both as a Caregiver and as someone who has experienced profound sadness--both at the personal/family level and st a societal level. These memories shapes and orient my reflection about grief, ministry towards "other" sufferers, and as a witness to the "despair" of the shadows that we all carry within ourselves.

    Grief really is one of those META-NARRATIVE humanity share with each other. And just like marriage ceremony of the West, say the US is radically different from that of a traditional Hindu wedding in India, the grieving process cannot be "processed" into a single formula but acknowledged, witnessed, and shared in all complexity and messiness. Yet, many assume and demand that everyone thinks like us.


    As a caregiver, my impulse is to universalize or singularize the experience of the other. However, when the art of the care-giving kicks in, I dive in to swim in dark unknown water. This causes me angst as I am tossed back and forth with the ebb and flow of the mourner's pain. In other words, I am exposed and vulnerable. Strength alone is not enough to touch my own pain and the grief of other. Perhaps, this is why "Immanuel" means so much to those in dark places . . .

    It is in these "transcended" and mundane humaneness, I see something beautiful: weakness brings us together. It shatters illusions and grounds both the mourners and caregiver in the valley of grief.

    To stay with the mourner, I am challenged to remember the "otherness" of the person. Unsurprisingly,our beliefs, attitudes, and values about death, dying, grief, and loss are initially molded by societal dictates. Within societies, various religious, philosophical, and ethnic groups further determine and refine the range of appropriate responses, feelings, behaviors, and rituals. While there are certainly wide differences among individuals within any society or culture, particularly in their psychological processing of grief, they are often more subtle than the profound differences among cultures. Societal and cultural influences may be difficult to recognize. These contextual determinants are so fundamental to our way of seeing the world that we often overlook their profound impact on how we feel and behave about loss.

    I am learning to see, feel, and think through pain and hope that in turning towards suffering of self and other is dangerous. This explains (my) calling-as-bigger-than-my-own-life.

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  5. Thanks, Tia! You are so right about our need to hold the absolute uniqueness of others' experiences together with our own sense of commonality and connectedness to one another. I count that to be a mystery as profound and powerful as the Holy Trinity. Thanks for stopping by.

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  6. Mark,

    Thank you for your thoughtful and helpful article on complicated mourning. Your words resonate with my experiences working with grievers and with my understanding of current grief theories. I appreciate your dispelling of notions of Elizabeth Kubler-Ross's linear stages of grief, predictable timetables in dealing with loss, and a goal of 'closure' around grief. These prescriptive patterns have contributed to grievers feeling like they are 'not grieving correctly,' which causes them to feel even more isolated.

    #3 Your comment about 'a rhythm to healing' is consistent with the "Dual Process" theory of grief. This theory states that people oscillate between a past orientation (actively grieving what was) and a present/future orientation (taking care of business at hand or working to create a new future that does not involve the deceased). The same widow who on Wednesday expressed her deep sense of accomplishment in fixing a faucet could not get out of bed on Thursday because of a fresh wave of grief.

    5. Yes. Grief is an emotional experience, not a cognitive one. It is a particularly challenging emotional experience because grievers often experience a cluster of emotions all at the same time, which can be confusing and disorienting.

    6. I appreciate your comments about "reality checks." While grieving, folks are trying to make sense of their new reality. Their interpretation of what happened and about the relationship they are grieving greatly affects who and how they will be as a result of this loss. Robert Niemeyer states that "Meaning Making" is the most important task in the grieving process. Your statement "You know, I just don't agree with that. I know that uncle Albert loved you deeply" helps the griever make meaning of her relationship with Albert in a positive way.

    7. Yes--a caregiver's job is not to "heal" the mourner; only God heals. And you make such a good point that caregivers can represent God's healing, sustaining presence. Attachment theory (long evoked in grief work) suggests that a secure attachment to God helps grievers feel comfort and hope even in the midst of devastating grief.

    9. Yes--grievers often go through profound 'disorientation' before they can experience 'reorientation' into a new normal.

    10. Great suggestion that the mourner read Psalms to feel edified in anguish, anger, and feelings of desperation. Language of lament is especially appropriate for grievers. In addition to affirming these emotions, Walter Brueggemann's naming of elements of 'orientation,' 'disorientation' and 're-orientation' found in lament psalms also resonates with some grievers.

    Your account of your friends' experience of her son's comforting presence in her car resonates with another contemporary grief theory: "Continuing Bonds." Whereas older grief theory suggested that "effective" grief involved divesting of emotional energy from the deceased and investing emotion in other relationships, "Continuing Bonds" theory affirms the experience of continued emotional connection to the deceased through memory, legacy, and love.

    There are many aspects to complicated mourning. One that I encounter often with grievers is that one loss evokes other losses, especially ones that were not fully grieved. Grievers may not even be aware of the multiple losses now brought to the fore because of this recent loss. Understanding and insightful caregivers can be helpful as grievers mourn present and past losses.

    Your friend was blessed to have you as a companion to her in her grief. All grievers should be so blessed. Thank you for an insightful and helpful article.

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    1. Thanks, Lee. Considering your experience and depth of study I am humbled by your affirmation. And you've given me some great leads to follow up in my own study-- Continuing Bonds, Dual Process and Meaning Making are areas I'll pursue. As is usual in this kind of presentation, I have to watch my tendency to get wrapped up in one aspect of the story I'm telling. I loved your bringing in Bruegemann's thought, which is a neglected dimension here- his article on the formfulness of grief in the lament psalms was one of the first things I read that helped me begin to understand grief from a biblical and theological angle. Thanks for adding so much to this discussion.

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  7. As a professional care-giver in my day job, I find myself on the other side now, so to speak, as a mourner. I have been personally reminded that we don't necessarily have to say bye to someone we love to be filled with that overwhelming sense of loss that Mark writes about. The kind of loss that keeps you on the verge of tears and the task of coping becomes a daily chore. That sense of loss can come when other valued and treasured things slip away too. In the case with our family, we have experienced compounded and complicated grief with a recent change in health status for our two adult daughters. Good health is easily taken for granted until something changes or something is lost. That process of mourning began for us over a year ago when confronted with the news that our adult daughters age 22 and 24 were visually challenged. In more recent months both daughters moved into legal blindness. My sense of grief compounded greatly with this development. Their vision continues to stair step downward and sadly, this condition is not treatable. The grief was much easier to bear when we were first made aware of it. But now and in more recent months, as we witness our daughter’s confrontation with the difficultly of everyday tasks, that sense of loss morphed into a much more acute phase as waves of it came and continues to come. Thinking about the future and the possible consequences is painful. The world is growing ever dim for my girls.

    I find Mark’s reminders about grief helpful as he states clearly that there really are no stages of grief, that there is no time limit and that no one really gets over their grief. Compounded and complicated grief, as I am experiencing it now, really does come in a rhythms or waves. That is what it feels like to me right now! And I've noticed that some days I do better with it than others. Some days seem to bring a high tide and others a low one, depending on various circumstances.

    The most helpful thing to me has been those gentle and kind reminders from my friends and family that our faith is a powerful and helpful resources as I seek to cope day by day. I really resonate with Mark when he encourages mourners to approach the loss then back away. That is truly helpful and speaks of where we are now. Thank you Mark for a great article and the good reminders to both care-givers and mourners. I know professionally and I’m being reminded personally that presence and real care can make a big different for those who grieve and hurt. So many of my friends and colleagues have decided to walk at my side just offering love and care. Thank you. So many have reminded me that God is the best source of comfort. Thank you. Some have gently reminded me of the reality I hope to experience more fully in the future, that quality life is not dependent upon visual acuity. Thank you. For all who care with no agenda to cure or change me or rescue me from my sadness. Thank you.

    Chaplain David Lowe

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  8. Wow, David. A beautiful meditation on loss and grief. You say so many things that can only be voiced by someone going through an experience like yours. You've blessed all of us with your courage and willingness to share experiences that are fresh and full of pain. May the Good Lord grant you every comfort and may God continue to watch over your daughters with tenderness and care.

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  9. Great post, Mark. It pulled together various helpful strands of thought with regard to grief, as well as practical suggestions.

    As I think about grief, one of the resources that has been helpful to me is written by philosopher Thomas Attig: How We Grieve, Relearning the World. In it he argues that grieving requires thorough and complete relearning of all that we have known and understood about our world with our loved one: Who we are to ourselves, who we are to the deceased, who we are to others in the absence of the deceased. As I read this book, my appreciation for the concussed nature of grieving deepened enormously.

    Your post here reflects similar and deep-seated themes.

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  10. Thanks so much for the lead on Attig Mike! This has been very rich discussion.

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  11. This was like a concise refresher course on walking with people in grief. Great stuff Mark.

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