Four months ago, all of our lives changed due to COVID-19. For many, it felt, and still feels, as though the world’s turned upside down. While everyone’s circumstances and responses to the pandemic are different, there is one common thread running through this collective experience, and that is grief and loss.

As grief expert, Dr. Alan Wolfelt, explains: “Grief is everything we think and feel inside of us whenever our attachments are threatened, harmed, or severed.” This encompasses our attachment to life as we knew it, our attachment to other people, to our jobs, our routines, our hopes and dreams, and more.

The pandemic has affected our relationships with others in a multitude of ways. We may have lost people we care about to this terrible virus. We may have lost the opportunity to physically see family members who are vulnerable. We may have lost the comforting power of touch after months of not being able to hug friends. We may be losing patience and positivity with our partners.

Other pandemic-related losses include the loss of livelihoods, loss of security, loss of routine, loss of structure, loss of a sense of normalcy, loss of ability to engage in rituals and events, including funerals, birthday celebrations, school plays, weddings, graduations, and once-in-a-lifetime trips; which can all contribute to a loss of meaning and purpose, loss of motivation, loss of identity. Grief sets in.

In grief, “we experience shock and disbelief,” writes Wolfelt. “We are anxious…We become sad and possibly lonely. We get angry. We feel guilty or regretful. The sum total of all these and any other thoughts and feelings we are experiencing as a result of the coronavirus pandemic is our grief.”

We are also experiencing anticipatory grief, which can manifest as feelings of dread and fear about future losses and about the uncertainty of what lies ahead. “Our minds and hearts are naturally trying to anticipate and prepare for what’s to come” (Wolfelt, 2020).

Grief is a normal, necessary, and universal response to loss. It is an ongoing, nonlinear process that knows no timeline and is not confined to discrete stages. Grief is not a problem to be solved, but rather an experience to be tended to. We cannot be cured of our grief, but we can heal over time.

In addition to the symptoms listed above, grief can include feelings of emptiness, yearning, hopelessness, hurt, confusion, and groundlessness. Grief is a whole body experience, affecting our physical, cognitive, emotional, psychological, and social functioning. Lynn Jonen, clinical psychologist at Sierra Tuscon treatment center, speaks to the individual nature of each grief journey, stating: “Our experience of grief is shaped by circumstances surrounding the death or loss and by the sum total of our cultural beliefs, life experiences, family, religion, and personality.”

But regardless of the different paths we all take in grief, contemporary grief literature points to two key elements involved in healthy navigations of loss, and those are:

1. Finding ways to express our grief

2. Having our grief witnessed

While there are many theoretical models through which to better understand and work through grief, I have chosen to share Alan Wolfelt’s Six Needs of Mourning, which he has adapted in a recent article called “Coronavirus and the Six Needs of Mourning” in order to focus on the grief needs of pandemic-related losses. The six needs are as follows:

Need 1: To acknowledge the reality of the pandemic and our grief. Acknowledging the reality of COVID-19 includes learning the facts about it, the precautions to take, and getting information from credible sources. Addressing the reality of our grief includes talking to others on a regular basis, and opening up and being honest about our thoughts, feelings, and fears.

Need 2: To honor all of our emotions. It is normal to experience a wide range of feelings about this pandemic, and for many of those feelings to be difficult to cope with. By being aware of them, naming them, and expressing them in some capacity, we can soften them.

Need 3: To think about the positives by spending some time each day considering the people and aspects of our lives that we are grateful for. Identify ways to feel, acknowledge, and/or express that gratitude, whether it’s by writing a card to someone who means a lot to us, saying a little prayer of thanks at the end of the day, keeping a gratitude journal, or paying it forward with a gesture of kindness toward someone else.

Need 4: To be kind to ourselves. It’s important to treat ourselves with patience, tenderness, care, and compassion – to treat ourselves as we would a good friend; to take care of our physical, cognitive, emotional, social, and spiritual realms. If we neglect one or more of those five parts of ourselves, we risk becoming unbalanced and intensifying our grief. Examples of how we can attend to ourselves during this difficult time include taking a walk, FaceTiming a friend, playing a board game with family, or doing a guided meditation.

Need 5: To search for meaning. It is common to now think of our lives as divided into “Before” the pandemic, and “After.” We are in a period of transition where life feels suspended and the future is full of unknowns. This can be a scary and certainly uncomfortable place to be. But when we stay with that discomfort and confront the kinds of spiritual questions that often come up in this “liminal” space, we are learning and growing in profound ways. When we are present to our pain, transformation occurs. Practicing mindfulness also enables us to soak up moments of pleasure, contentment, and joy. Focusing our awareness on the here and now, without judgment, as we engage in activities we enjoy, is an essential part of coping with coronavirus-related grief.

Need 6: To reach out to others to give and accept support. Human beings need contact and connection with others. Lean on other people during this time; deepen your relationships, and build new ones. Express your concerns to those that you trust, and try to be empathic as they lean on you, too. We now have to rely on technology more than ever before, and it’s important to utilize the tools at our disposal even if they’re not our ideal or preferred modes of communication. Video calls tend to feel the closest to in-person encounters, second to phone calls. Emailing, texting, and chatting through social media can also be helpful when used intentionally. While often forgotten, handwritten letter writing can also be a special way to stay in touch. The important thing is maintaining the kind of contact that facilitates reciprocal support and compassion.

 Mourning is the most difficult work we will do in our lifetimes, but when mourning is done “well,” says Wolfelt, we can gain clarity about what really matters in our lives, and let go of some things that don’t. Dr. Jonen hopes that our collective experience with this global pandemic will provide our society the wakeup call we need to start appropriately addressing grief, which is too often seen as something we have to deal with by ourselves and “get past” as quickly as possible.

“…it almost seems as if something this catastrophic was needed to shake us out of complacency and the subscription to our culture of ‘more, more, more, speed, information, keep going no matter what’ mentality,” she states. “COVID shut us all down very quickly; it forced us to stay in our homes, many of us to leave our jobs, all of us to reevaluate priorities… We have an extraordinary opportunity at this moment to collectively transform how we move through grief and trauma.”

Sources:

Jonen, L.P., PhD. (2020). Understanding Grief and Trauma in Today’s World [PowerPoint slides]

https://naccme.s3.amazonaws.com/Sierra+Tucson+July+2020/Sierra+Tucson+July+2020+Webinar.pdf

Wolfelt, A.D., PhD. (2020, April 20). Coronavirus and the Six Needs of Mourning. Center for Loss and Life Transition.

Retrieved from https://www.centerforloss.com/2020/04/coronavirus-six-needs/

Emily Lockamy, MA, LCMHC offers individual grief therapy and grief support groups at Chrysalis Center.

Call 910-790-9500 to set up an initial appointment.

The parental loss of a child is devastating and widely considered the most tragic type of loss. But less commonly talked about is the loss of a baby, during or after pregnancy – an incredibly painful experience that can often lead to complicated grief. Today, October 15^th, is Pregnancy and Infant Loss Remembrance Day – a day to honor the lives of those lost through miscarriage, stillbirth, SIDS, and during infancy.

About 10 to 20 percent of known pregnancies end in miscarriage, and stillbirth occurs in about 1 in 100 pregnancies. Each year in the United States., about 2,500 infants die of Sudden Infant Death Syndrome (known as SIDS), and in 2017, the rate of infant mortality was 5.8 deaths per 1,000 live births.

Many factors complicate the grief process for these heartbreaking losses, including:

• The sudden, unexpected nature of the death, leaving little or no time to mentally prepare
• The absence of a definite cause in some cases, which often leads to guilt
• The involvement of the legal system in cases of sudden infant death, which can add significant stress and trauma
• The impact on siblings (older siblings who resented the arrival of the new baby tend to feel guilt and remorse)
• Intense strain on a marriage or relationship, often involving tension, communication breakdowns, and anger
• Fear of having (or trying to have) another child
• Denial
• Feeling that the loss is socially-negated (common with miscarriages; a woman may have not announced her pregnancy yet, and she may feel shame and isolation in a society that prioritizes motherhood)
• Self-blame or blaming the other parent/one’s partner
• Loss of expectations, hopes, and dreams for the child’s future – “the family grieves as much for what they might have had as for what they’ve lost” (Worden, 2009).

While each situation is different and everyone grieves differently, it’s so important for parents who suffer pregnancy or infant loss to have a space in which to share about their grief, where they can feel heard, held, validated, and supported. Individual grief counseling can be a good place to start, and joining a support group for parents with similar losses can be immensely helpful.

Additionally, finding ways to memorialize one’s child can be therapeutic and healing. This may include:

• Naming your baby
• Having a memorial and/or funeral service
• Lighting a candle or planting a tree in their honor
• Writing a poem or letter to your baby
• Establishing rituals to pay remembrance to your baby during holidays and special occasions, such as putting an ornament on the tree each year for them
• Creating a collection of items related to them, such as pictures, footprints, a lock of hair, sonograms, cards received from friends

What bereaved parents need others to know is that while their babies’ lives were short, they mattered, and they always will. Mothers who suffer miscarriages are mothers. Babies gone too soon have made a forever impact on those who love them and carry out their legacy. Today, let us hold their memories and their parents in our hearts and thoughts.

Resources:

http://nationalshare.org/

http://unspokengrief.com/

Local: https://www.facebook.com/groups/thehopeproject910/?fref=nf

Source:

Worden, J. William. Grief Counseling and Grief Therapy: a Handbook for the Mental Health Practitioner. Springer Publishing Company, LLC, 2018.

Emily Lockamy, MA, LPC is a licensed professional counselor at Chrysalis Center who specializes in grief counseling. 

‘Tis the season for invitations – to holiday parties, performances, Secret Santas, tree lightings, cookie swaps, and other fun-filled, festive gatherings.

But for people who are wrestling with mental health concerns or painful life transitions, like a divorce, a recent loss, or serious depression, such activities can seem overwhelming and unappealing.

But the pressure to appease well-meaning friends and family members who request your presence at such events can feel immense. You may feel as though you can’t say no for fear of disappointing them, even if you know that accepting their request will only bring more stress and distress at a time when you feel like you’re hanging on by a thread.

Declining invitations can feel difficult, but setting boundaries and doing what works best for you as you try to cope and recover is important. And there are several ways in which to make the act of saying “no” feel more doable:

1. Use Mindful Self-Compassion to justify your choice.

Self-compassion involves being kind to yourself during difficult moments – instead of berating yourself for not being “strong enough” to want to celebrate this holiday season, speak to yourself like you’d speak to a close friend. Say, “This is a period of pain… Pain is a part of life… May I be patient with myself and give myself the compassion I need.”

Instead of blaming or shaming yourself for “letting others down,” acknowledge your shared sense of humanity: “Everyone struggles at some point. I’m not alone.”

2. Recognize your rights as a human being.

As leading expert on self-compassion, Dr. Kristin Neff, points out: none of us signed a written contract before birth promising that we’d be perfect, that we’d never fail, and that our lives would go exactly the way we want them to. So why should we hold ourselves to unrealistic standards?

Experts in Dialectical Behavior Therapy (DBT), explain that we all have legitimate rights that reflect our value as humans. A few rights in particular are key to remember when it comes to navigating relationships and having hard conversations:

“You have a right to need things from others.

You have a right to put yourself first sometimes.

You have a right to say no; saying no doesn’t make you bad or selfish.

You have a right not to justify yourself to others.

You have a right, sometimes, to inconvenience or disappoint others.”

It’s perfectly okay to exercise those rights when needed.

3. Use assertiveness skills to respond.

The ability to say no is an essential part of healthy communication.

“Saying no is simple and hard at the same time,” write authors of the DBT Skills Workbook, McKay, Wood, and Brantley. “The words are simple, but often it takes courage to say them.”

Effectively passing up an offer entails just two steps:

1. Validating the other person’s needs or desires.

Example: “I appreciate you including me. You always throw great dinner parties.”

2. Stating a clear preference not do it.

Example: “But I’m really not up for it this year. I need to take some time to rest.”

While it may feel uncomfortable at first, the more you practice being assertive – confidently expressing what you want, need, or believe, while respecting others’ feelings – the easier it will be.

4. Remember that boundaries make for better relationships.

We can’t please all the people all the time, and we can’t be everything for everyone. And even if we could, it would come at a high price. Maintaining good boundaries is one of the healthiest things we can do for ourselves and our relationships. Protecting our own boundaries helps us avoid feelings of hurt and resentment, and enables us to take better care of ourselves and experience a clearer, more positive self-concept. Respecting others’ boundaries helps us cultivate more balanced, supportive, and caring connections. And sometimes, having firm boundaries means saying no. 

5. Recognize that all feelings are valid, but no feeling is final.

It’s hard to be in a dark place during the “most wonderful time of the year,” but these feelings won’t last forever. Give yourself permission to hibernate a bit, or change up your traditions (knowing that you can always revert back to being busier and more social next year). But also be mindful of the tendency to isolate and withdraw, which can worsen depression. Try to seek and accept support in ways that feel helpful.

Lastly, while you may assume that all the bright lights, merry music, and cheery people will surely only fuel your low mood, try to stay open to the possibility that being around others and getting out of your comfort zone may help lift your spirits.

If you do decide to go out, you can give yourself an out.

Example: “Gotta get home to take my dog out!” or “I think I’d better leave at intermission.”

You can also say “yes” to something and reserve the right to change your mind, at any time.

If you do opt to don your “ugly sweater” and attend the annual bash, it can help to plan ahead and anticipate difficult feelings that may surface and how you’ll handle this (if you’re at a loss for coping skills, therapy can help). At the same time, try to practice positive thinking by interrupting anxious ‘what if’ thoughts with a different kind of question: “What if I have a great time?”

Most importantly, be gentle with yourself this season. It’s not an easy time of year, but pain does not have to equal suffering, and suffering does not have to be done in silence. If you’re finding that you need to talk to someone, call 910-790-9500 to set up a therapy appointment at Chrysalis Center for Counseling and Eating Disorder Treatment.

And remember, ‘no’ can be a full sentence.

Emily Lockamy is a licensed professional counselor associate and freelance writer passionate about helping people find their way through grief, anxiety, and other struggles. Emily also facilitates Healing Words: A Therapeutic Writing Group, helping people process emotional pain through the art of writing.

(Image source: BBC)

Joan Didion, once asked: “Was it only by dreaming or writing that I could find out what I thought?”

The acclaimed author explains, “I write entirely to find out what I’m thinking. What I’m looking at, what I see and what it means. What I want and what I fear.”

Didion makes a profound point about the power of writing to increase self-understanding. A power that is accessible to all of us really, regardless of whether we are published authors or even “good” writers.

Recent research shows that the act of writing can, in fact, help us become aware of important truths and gain a firmer, fuller grasp on who we are and what we’ve endured. It can help us make meaning from difficult experiences, and more effectively integrate events and emotions into our lives, facilitating growth, resilience, and recovery.

“Writing allows you to access your wider mind, a wiser, more encompassing place deep within,” writes Susan Zimmermann, author of Writing to Heal the Soul: Transforming Grief and Loss Through Writing. 

But not every type of writing produces such results.

Louise DeSalvo, teacher and author of Writing as a Way of Healing: How Telling Our Stories Transforms Our Lives, explains that restorative and transformative writing involves writing in an intentional way, wherein you attempt to connect past experiences with the feelings you had at the time, and the feelings that come up now as you process that trauma, loss, or struggle. DeSalvo asserts that in putting pen to paper and linking our thinking and feelings from the past and the present, we can develop greater insight and a sense of empowerment — therapeutic effects that we miss out on when merely taking to the page to vent (which is shown to be unhelpful) or to write without any direction.

Focused writing becomes even more impactful when we take the step of sharing our words with empathic listeners, explains DeSalvo, as this audience can help reflect what we have expressed, identify gaps in our narrative, and open our eyes to patterns or personal strengths we cannot see.

Chrysalis Center for Counseling and Eating Disorder Treatment is now offering a new 6-week group that offers the opportunity for people to explore their emotional wounds through research-backed writing methods that provide the paradoxical structure and freedom shown to alleviate suffering and promote mental health, self-mastery, and connection. Writing exercises that both tap into the unconscious and create a safe container for the chaos of strong feelings. Writing that takes place in a comforting space free of judgment. Writing that unlocks the potential for peace.

Healing Words: A Therapeutic Writing Group is open to adults of all ages going through challenges that they wish to process through the art of writing. Perhaps you have lost a loved one, or an important relationship, or your home and/or sense of security after the hurricane. Perhaps you’re caregiving for a sick family member, or bringing a baby into the world, or dealing with the aftermath of an accident, an illness, or insecurity. Perhaps you feel lost or crippled by anxiety.

Whatever you’re contending with, writing as a therapeutic modality may be able to help you “discover and fulfill your deepest desire. To accept pain, fear, uncertainty, strife. But to find, too, a place of safety, security, serenity, and joyfulness. To claim your voice, to tell your story.” (DeSalvo, 2000).

To learn more about Healing Words, please email the group facilitator, Emily Lockamy, MA, LPCA at emily.lockamy@chrysaliscenter-nc.com. To register and schedule your group screening, call 910-790-9500.