SARAH SCHAFER: Hi. My name is Sarah Schafer (ph), and I have a tip for being a thoughtful friend as an adult. Whenever a good friend of mine has a baby, I make a note of that in my contact info for my friend. I make a note of the baby's birthday and the year that they were born, and I also make a calendar event for the child's birthday so that when their birthday rolls around, I can remember to wish my good friend congratulations that their son or daughter is having a birthday. That's it. Thanks.
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STEPHANIE O’NEILL, HOST:
We're all going through a lot of grief these days. And as this pandemic progresses, more of us will come into close contact with losing someone important to us. Now obviously, even without a rogue virus sweeping the globe, death happens. Whether you lose your partner, your parent, your child, your friend - grief is grief. It's your loss. It's important. And it can leave you feeling so crushed you can't seem to catch your breath.
I'm Stephanie O’Neill, a regular NPR contributor covering health policy, here with a beginner's guide to navigating grief. In this episode, I'm going to walk you through tips for moving through grief. Although this advice is focused on the death of a loved one, much of it also applies to other loss you may be experiencing. So no matter your grief, this will help you better ride the waves and morph the loss into healing.
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O’NEILL: So here's something interesting about grief - it's both a universal human experience and a profoundly personal one that shows up in ways totally unique to each of us. How you grieve one person will likely be completely different than how your friend or sibling does or even how you grieve another person you love and lose. And I'll help you hang on because this is really hard stuff. But take it on fully, says grief expert Terri Daniel, and it can shake you alive and awake like nothing else.
TERRI DANIEL: It's an opening. And it's an opening to a new world - a new self, higher awareness, spiritual growth - whatever you allow to come in. And it leads to greater peace in life. And that's where the healing comes from is seeing that wound as an opening instead of a wound.
O’NEILL: So my loss happened in late September 2017. That's when sand and slurry from road construction took down my boyfriend of three years as he rounded a street corner on his motorcycle. The accident broke Eric's (ph) back and neck in several places. Heroic efforts by paramedics got his heart restarted after 45 minutes of CPR, but he never regained consciousness.
There's so much I can't remember about that night, along with minute details and memories I'll never forget.
Two days after that accident, doctors unplugged Eric from the machines keeping him alive, and I plunged into this wormhole of grief that I didn't think I'd ever climb out of. For two weeks, I didn't eat. I couldn't. And then for several months, I barely slept. Anxiety and exhaustion made concentrating on anything beyond work really hard to do.
Still, I knew I was fortunate to have friends who themselves had experienced big tragedies, people like grief expert and counselor Terri Daniel. She's among those I still check in with whenever painful stuff bubbles to the surface - as has been happening lately.
So I found it interesting as I'm working on this LIFE KIT that it started bringing up, you know, issues again for me of grief, of losing Eric. And it's become kind of hard to do this because I'm kind of facing that - those feelings again. So is that - is that normal?
DANIEL: Not only is it normal, it's good. It's good for you. I mean, there's a reason why you're doing this work. There's a reason why you chose this story and this subject matter - because your heart is asking for recognition, for healing. And so you know, there are no accidents. You're right here at the right time talking to me because you do have some grief. And it will resolve itself in little steps, in drips and drabs, every day in different ways forever.
O’NEILL: And Daniel knows this well. Back in 2006, she lost her 16-year-old son, Danny, to a rare metabolic disorder called metachromatic leukodystrophy.
DANIEL: It was a progressively degenerative disease. He went from being a perfectly normal kid to in a wheelchair unable to speak or manage his own body in any way.
O’NEILL: That life-changing experience led her to work as a hospice volunteer for several years. And that led her back to school, where she became a certified trauma and grief specialist and then got her doctorate in pastoral counseling.
And she brings us to our first takeaway - you've got to just be with your grief, and it's probably going to be pretty messy and uncomfortable.
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DANIEL: Being present with grief is learning how to be 100% in this moment and take a breath and get to the next moment, take another breath. That's how intense it is with really, really acute grief.
O’NEILL: By connecting with our grief and embracing it, she says, we open ourselves up to healing from the loss. Grief, she says, provides the way.
DANIEL: We're not supposed to hate it. As weird as it sounds, we actually want to find a place where we can be present with it rather than be in resistance to it. And it's very difficult to just sit and be still with discomfort. It's an old Buddhist teaching of sitting with uncertainty, sitting with discomfort. And that's the real tool that we need for being with grief.
O’NEILL: Daniel compares it to sticking your hand into a fire. The instinct is to immediately pull it away to avoid the pain - or in the case of grief, to numb it with work, alcohol or other drugs - which is exactly what you don't want to do. Grief, she says, demands that we walk into it with open arms and open eyes.
DANIEL: If we can't be in it fully, then we're not going to heal. We won't have a healthy mourning process.
O’NEILL: And that can wreak havoc in your life, says Sonya Lott. She's a Philadelphia-based psychologist who specializes in complicated grief, which we'll touch on in a bit.
But for now, you might be thinking, I don't want to be with my grief. But the point she wants to make is - you just can't sidestep this.
SONYA LOTT: There's no way around it. We have to move through it, or it will continue to show up in insidious ways in every aspect of our being - physically, cognitively, emotionally, spiritually.
O’NEILL: Now, you might be familiar with something called stages of grief. But Daniel says, when you lose someone, they don't apply.
DANIEL: There are no steps and there are no stages.
O’NEILL: So no steps, no stages. The stages of grief concept comes from death-and-dying expert Elisabeth Kubler-Ross. And she originally developed them to describe the denial, anger, bargaining, depression, and finally acceptance that a terminally ill person goes through as they face their own death. Instead, Daniel says, what can be more useful for grieving a loved one is to focus on tasks.
DANIEL: We do use the word tasks. There are tasks of grieving.
O’NEILL: Tasks can help you be more present with grief. Psychologist William Worden is the one who developed the tasks of grieving concept, which spans the entire grief process. Generally speaking, they involve the acceptance of the loss and processing that loss, then adjusting to life without the deceased person and finding ways to maintain an enduring connection with them as you continue your life.
And that last task, by the way, can be as simple as framing a favorite photo of the deceased person, planting a tree to honor them, celebrating their life each year on their birthday - whatever works for you.
Daniel says, think of the tasks as you would think of any task you do as part of your day-to-day life.
DANIEL: And that's why we call them tasks because you're working through something. So a task is like cleaning your house. You have to clean the bathroom. You have to wash the dishes. It's like that.
O’NEILL: And just like keeping a tidy home, tending to grief is an ongoing gig. Which leads us to takeaway No. 2 - grief is a lifetime journey.
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O’NEILL: I remember hearing this during the early days of my recent grief. And at first, I was like, no way I can do this for the rest of my life. But then I read something that described exactly how I was feeling. It's from an unknown author who says, grief comes in waves and that our loss is like a shipwreck. At first, you're just clinging to the pieces of the wreckage, trying not to drown as relentless waves slam down on you. But then the waves start coming farther apart. They still slam you hard, but in between, you have time to breathe and function. And then they start getting smaller and even farther apart, and you can see them coming. They no longer wipe you out. You learn to survive and hopefully to thrive.
It's been more than 13 years since Daniel lost her son. And occasionally, one of these waves hits her shores. And when that happens, she says, she embraces it.
DANIEL: I like to say, you know, hello, grief. You're my friend. I hate you (laughter). You know, I don't want you to be here, but I'm going to make friends with you because I can't get rid of you. So come on in and sit with me, and I will be your friend. And what you're doing by doing that is you're integrating with the loss. And when you allow it to integrate into who you are and into your daily life rather than separating from it, that's how you heal. That's how it strengthens you.
O’NEILL: But it does need expression, and that's takeaway No. 3 - express your grief.
DANIEL: One of the things a grieving person needs more than anything else is to tell their story and be heard.
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O’NEILL: In our death-phobic society, talking about loss and grief is often considered taboo. Grief, that thinking goes, is something you need to recover from. But Daniel says, that's not true. Grief is a natural and normal process, not an illness, which means that for most people, it doesn't require therapeutic or pharmaceutical interventions.
Just make sure to express it - paint, sculpt, throw clay or journal by taking pen to paper, typing your feelings into a Word doc or just talking into the voice memo app on your phone. And you don't have to do art. You can even express your grief with running or baking or volunteering. Also sharing your story with those who understand can be profoundly healing. So reach out to trusted friends or family who get it. And if you need to talk more, consider visiting a grief support group or getting some one-on-one grief counselling. But, Daniel says, there is a limit.
DANIEL: If you're still going once a week and telling your story again and again to a therapist after a year, you're spinning your wheels.
O’NEILL: That being said, if you're stuck in raw and overwhelming feelings of grief long after the loss - to the point where it interferes with your daily functioning - therapy may be just what you need. And this is where we turn back to psychologist Sonya Lott. She's the one who specializes in treating complicated grief.
LOTT: So complicated grief, also known as prolonged grief disorder, is diagnosed when a person has experienced the death of a loved one at least a year ago and is still feeling as if their grief is acute.
O’NEILL: Just to note - the year timeframe Lott mentions is not a magic number. It's just a way for therapists to help diagnose the condition.
Lott says this type of reaction is more likely to happen when the loss of your loved one is unexpected or sudden - like death caused by suicides, accidents or drug overdoses. Grief can become complicated when you blame yourself for your loved one's death, when you feel as if you should or could have done something to stop it from happening. And then, Lott says, there's a host of other risk factors.
LOTT: People who've had a multitude of losses in a short period of time, so there's not enough space in between one grief process and when another one starts. People who had preexisting anxiety or depressive episodes may be more prone for complicated grief. If the loss of a loved one was traumatic in any way, that increases the likelihood of a person getting stuck in the grief process.
O’NEILL: Understanding what might derail your healthy grieving can also lead you to healing those prior wounds, which is another transformative role a walk with grief offers us.
For that work, Lott suggests an evidence-based treatment called complicated grief therapy. You'll have to find someone like her who specializes in this, and it involves between 16 and 20 therapy sessions. By the way, LIFE KIT has a whole episode about how to find a therapist if you need help. We'll link to it on our episode page.
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O’NEILL: And now on to takeaway four - healthy grieving involves ping-ponging between loss and restoration. That comes from a theory of bereavement that's been around for a couple of decades. Daniel says in real life, it looks something like this...
DANIEL: So you're sad, you're crying, you can't get out of bed, you're angry - that's loss. Then you get out of bed and you go write in your journal and take a walk in nature - that's restoration. Back and forth, back and forth - as long as you're moving between those two focuses all the time and you're not stagnant, you're going to be fine.
O’NEILL: So feeling bad is actually good, and feeling good too soon is actually not good because it suggests you could be sweeping stuff under the proverbial carpet, which is an unhealthy way to deal with loss.
DANIEL: You can't live in one or the other. You have to keep it balanced. However, as time goes on and you move more into resilience and healing, you are in restoration all the time. I'm pretty much in restoration 99% of the time.
I mean, my child died 13 years ago. If I was spending a lot of time in loss, still, I would not be in good shape. So when do I focus on my loss? Something I see in a movie will make me cry. Or if I'm talking to someone else who's lost a child, of course, it always triggers me, and I cry right with them.
O’NEILL: So that's where we aim to go with healthy grieving. Yet don't be surprised if restoration makes you feel uncomfortable. Daniel says that happens to a lot of grieving people.
DANIEL: This is a really important point. It's OK to be OK. And people feel guilty if they start to feel better, that they're starting to enjoy life again. Maybe your husband died, and now you're dating again or you fall in love. There's so much guilt that comes with that. And that's all restoration. We feel that holding onto our pain keeps us connected to our loved one, and it's not true.
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O’NEILL: Which brings us to our last point, takeaway five - grief can break you open to a new you, if you let it.
DANIEL: What we try to do with people is to help them understand that change is trying to happen, and you're supposed to change. And the new life is coming in. It's going to replace the old life, and it's going to bring all kinds of new stuff that isn't necessarily bad. In fact, it's good.
O’NEILL: What I've experienced is this deeper appreciation of time spent with people I love. 'Cause I just, you know, you never know when you're going to go to the store and not come back or they're going to go to the store and not come back. And it may sound morbid, but to me, it sort of adds a deeper color to life.
DANIEL: Yeah, I love that. You definitely learn that. You also find your inner strengths. So, you know, there's so many levels of those things. And you find that maybe you have some social skills you didn't know you had. You can interact with people by yourself instead of as part of a couple.
O’NEILL: And for many of us hit with a big grief, the healing period can open an entirely new direction in life - as it did for Terri Daniel. She's now the author of four books on death and grief. She teaches college courses on death and bereavement and offers grief workshops and training for end-of-life professionals throughout the U.S.
DANIEL: The term that we use in counseling is meaning making. So you make meaning out of your life. So what a lot of people do is though get involved in a charitable cause or start a foundation for the disease that their husband died of. They'll start support groups. They'll write a book, a blog.
O’NEILL: Side note - you don't have to write the Great American Novel or become an Internet sensation. Even a slight shift in perspective of who you are can be hugely valuable to your new life.
DANIEL: There's, you know, endless things that you can do like that.
O’NEILL: Like doing a LIFE KIT for NPR on grief?
DANIEL: That's a perfect example. I know somebody who's doing that, by the way (laughter).
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O’NEILL: So let's recap. Takeaway one - learn to be with your grief, no matter how messy it is. Grieving a loved one doesn't happen in steps or stages. There are just tasks you'll need to get through in order to heal and to keep your emotional house tidy. Takeaway two - grief is a lifelong journey. The acute pain will subside, but it never fully goes away. And that becomes just fine as it matures into an old, comfortable friend.
Takeaway three - grief needs expression. Paint, journal, hike, volunteer - whatever feels right. And share your story with trusted friends or family who get it. Individual or group counseling is also an option. Most likely, you're not going to require any therapy or medical intervention unless you fall into complicated grief.
Takeaway four - ping-ponging between loss and restoration is a sign of healthy grieving. And when you do finally find yourself mostly in restoration mode, you might feel guilty. So remind yourself that returning to a full life is a good and necessary part of the healing process. Takeaway five - if you let it, grief can break you open to a new you.
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O’NEILL: For more NPR LIFE KIT, check out our other episodes. We cover everything from how to start a garden to how to get therapy when you can't leave the house. You can find those at npr.org/lifekit. And if you love LIFE KIT and want more, subscribe to our newsletter at the npr.org/lifekitnewsletter. If you've got a good tip about getting through grief or otherwise, leave us a voicemail at 202-216-9823, or email us at firstname.lastname@example.org. This episode was produced by Meghan Keane who's also the managing producer. Beth Donovan is our senior editor. Our digital editor is Beck Harlan and our editorial assistant is Clare Schneider. I'm Stephanie O'Neill. Thanks for listening.
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