358 SelfWork: What You've Been Taught About Grief May Be Wrong

We certainly have had – and the world has had – our fair share of reasons to grieve. Wherever you live, you felt the fear and loss of the pandemic. Add on to that, the impact of hurricanes, tornados, drought, fires, floods,  war, racism, political unrest, violence… we’ve got it all - some countries more than others. But these events are also a backdrop for whatever happens in our personal lives – people who we’ve loved dying, losing a job, having to move or even to escape from where you’ve lived, developing a severe mental or physical illness or one that’s chronically debilitating, being abused… The list goes on and on.

And we need to grieve.

Yet, one of the ironies  is that the model we’ve been taught – in a very “this is how you should be grieving” kind of way – was created to help us understand what the person dying might feel and wasn't created to describe the grief of people who are alive and grieving loss.

What’s grief really like? How do the stages that Kübler-Ross help? How do they hurt? What are the effects of your culture or faith alter your experience of grief? How is the Internet changing the way we grieve?

The listener email for today is from a woman whose sense of emotional stability has decreased after the death of her father – and she has no relationship with her mom. She uses the term, “I feel orphaned.” So as always, we’ll talk about what you can do about it.

Before we go on,  I’d like to invite you to listen and watch my TEDxBocaRaton talk.. Here’s one of the many reviews… "Dr. Rutherford, what a beautiful talk. I watched it several times. We can all learn to recognize the signs and be ready to support those who might be silently struggling. This TEDx talk is a powerful reminder to be more attentive to the people around us, listen beyond the surface, and offer support without judgment."

Click here to listen!

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Vital Links:

Heidi Bastian's article in The Atlantic

Article: It's Time To Let The Five Stages of Grief Die

Dr. Franco's article on cultural differences in grief.

You can hear more about this and many other topics by listening to my podcast, The Selfwork Podcast.  Subscribe to my website and receive my weekly newsletter including a blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!

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Episode Transcript: 

Intro:

This is SelfWork and I'm Dr. Margaret Rutherford. At SelfWork, we'll discuss psychological and emotional issues common in today's world and what to do about them. I'm Dr. Margaret and SelfWork is a podcast dedicated to you taking just a few minutes today for your own selfwork.

Welcome or welcome back to SelfWork. I'm Dr. Margaret Ruthford. I'm so glad you're here. I started this podcast almost seven years ago now to extend the walls of my practice to those of you who are already interested maybe in therapy or you were just interested in psychological stuff, to those of you who might have just been diagnosed or you're looking for some answers. And to those of you who might just be a little skeptical about the whole mental health horizon, so welcome, welcome to all of you.

We certainly have had, and the world has had their fair share of reasons to grieve recently. Wherever you live, you felt the fear and loss of the pandemic. Add onto that, the impact of hurricanes, tornadoes, drought, fires, floods, war, racism, political unrest, violence - we've got it all - some countries more than others, but these events are also a backdrop for whatever happens in our personal lives, people who we've loved dying, we lose a job, we have to move or even you, you have to escape where you've lived. You develop a severe mental or physical illness or or that's chronically debilitating or someone you love does or you're being abused.

The list goes on and on and we need to grieve.

And yet one of the ironies, and what I want to address in today's SelfWork is that the model we've had taught to us in a very "this is how you should be grieving" kind of way, was initially met or designed to describe the stages of grief for the person who is terminally ill or dying themselves. It's Elizabeth Kübler Ross's five stages of grief. It was never meant for the people who were alive in grieving a loss.

So that's what we're gonna talk about today. What's grief really like? How did the stages that Kübler Ross suggests help? How do they hurt? What are the effects of your culture or faith and how does that alter your experience of grief? How is the internet changing the way we grieve? That's an interesting kind of subject.

The listener mail for today is from a woman whose sense of emotional stability has decreased after the death of her father, and she has no relationship with her mom. She uses the term, "I feel orphaned." I've heard so many people say this, so we're gonna talk about it today on SelfWork.

Before we go on, I'd like to invite you to listen and watch my TEDxBocaRaton talk. Here's one of the many reviews, "Dr. Margaret Rutherford. What a beautiful talk. I watched it several times. We can all learn to recognize the signs and be ready to support those who might be silently struggling. This TEDx talk is a powerful reminder to be more attentive to the people around us. Listen beyond the surface and offer support without judgment. Together we can break mental health stigma and create a more compassionate and understanding society."

So I will have the link in the show notes or you can just put in Dr. Margaret Rutherford TEDx and it'll lead you right with my YouTube. And of course, if you like it, please say you do or check that off and even leave a review. I'm beginning to get asked to speak about perfectly in depression directly because of this TEDx talk. And so that's a wonderful and very helpful way you can help me spread what I believe is a very important message. Thanks, my gratitude to y'all.

Episode

Elizabeth Kübler-Ross, the psychiatrist who first developed and wrote about five stages of grief, gathered her ideas from conversations with dying patients. She talked to them and she watched the grief that they go through. And yet it was snapped up by others to describe what everyone who is grieving must go through. In fact, it doesn't make a lot of sense when you think of it and it's even becomes something you should be going through, which is really ridiculous. For one thing, the stages are interactive, but somehow people have felt bad that those stages weren't part of their experience.

In an article put out by McGill entitled, it's Time to Let the Five Stages of Grief Die. The author state and I quote while she was a psychiatry resident in New York, Kubler Ross realized how little attention was paid by hospital staff to terminally ill patients and how little medical knowledge there was regarding the psychological aspects besetting patients facing death.

She worked extensively with terminally ill patients throughout her medical school career and continued to study and teach about such topics. She was also criticized by academic researchers for not running a real study. Instead, she used conversations with a dying as her basis for putting the stages forth and wanting medical staff to be a better attuned to what was going on with these patients.

Now, what are those stages that she was describing? You may have thought I needed to know this way before now, but here we go. Denial, anger, bargaining, depression, and acceptance. She asserted that these stages weren't rigid. You could feel or express them at any time. Denial that you were dying or that you had a serious illness might make you not seek treatment or refuse treatment. Keep how serious your illness was out of your consciousness. Anger is the second one, anger that it feels unfair that you're not ready to die, that you have more life to live.

The third one is bargaining. If I can just get better, I'll never do X, Y, or Z again, or I'll start doing X, Y, or Z. Then there's depression, sadness over past choices, sadness over not having control, sadness that you're leaving the people you love, the life you've been fulfilled by and thus acceptance, realizing there's truly no more you can do. Acceptance that you won't see your grandchild born or your kid graduating from high school. Of course, how you grieve is shaped so much by the culture you live in or in the rituals, the religion you follow or that you have faith in general. Dr. Marissa Franco, who we've had here as SelfWork as a guest, she's really cool, writes in Psychology Today that research suggests that when we're helping our loved ones cope with grief, we should consider what they find.

Most supportive people in the Asian and Asian American communities for example, may prefer spending time with close others without talking about their grief. While people in the European American community may want more explicit emotional support. So she's pointing out that we need to understand and be aware of how a certain person may be grieving, how their culture influences them, how their faith influences them, and what you may need or want to do to be respectful of that because that's what's important. Even with the best of intentions, you may make someone's experience of grief more difficult or if they really want that kind of support from you, they want to talk about their loved one who's gone. Then you hold back obvious emotional support and you don't wanna do that, or at least most of us don't. actually to know what's truly helpful. You could of course ask and not assume, how would you like for me to support you?

So what role does a belief in life after death have on grief? I looked at several different studies but was drawn to one whose results showed that people reporting no spiritual belief had not resolved their grief. By 14 months after the death, participants with strong spiritual beliefs resolved their grief progressively over the same period. And then people with low levels of belief showed little change in the first nine months but thereafter resolved their grief. So basically a spiritual belief seemed to increase the likelihood that you'll resolve your grief earlier and even a small bit of relief helped to resolve grief more quickly. That's important.

But let me quickly say that's not necessarily been what I've seen in my own clients, and I've watched many people grieve. Because so much of what matters is the timing or the way someone died. Did you have a chance to do what's called anticipatory grieving? Allowing yourself to feel what it's going to feel like to lose someone you love, whether you got to say goodbye, whether you feel to blame or partially responsible for their death or you were told that you were responsible.

Grief can often challenge your belief in some of these instances. If there's a God, then how did this happen? Now for those of you listening who say, if you believe in heaven, if you believe in life after death or if your religion is Buddhist or Hindu or whatever it is, that may of course be very comforting. I'm not saying that, but here's an example. I worked with a man years ago whose alcoholic parents had told him he was to blame for a sibling's death when he had been only a child himself. When it occurred they were inside drinking and this 10 year old boy was tasked with watching his four younger siblings and one of them got hit by a car.

So obviously when you're blamed, when you have a terrible time processing your own grief, or maybe you lose contact with others who you might be grieving with, you've got to go back to college or you've got a new job or you've quickly moved to a new home. So those that you might be grieving with are no longer there. Of course, our modern technology helps with that, but still, but there's also the possibility that you are not even allowed to speak of your mom who died because your father has remarried.

So many factors affect your grief, how you are encouraged to express it or how you're not allowed to do so again, faith, a certain structure of what happens after death. If you believe, that can certainly be helpful, but from my perspective at in my experience, that suddenly you just don't grieve. That's far too simplistic. Let's stop for a moment for a brief message and offer from BetterHelp where you just might turn in this kind of grieving situation or time.

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Episode Continues

Sometimes when I'm looking into a topic like I did today, I realize that someone has said something born from their their own experience and expertise that I just can't say better. So when I read this Atlantic article by a grieving mother who's also a researcher, Heidi Bastian, I knew I was having that experience again. She went looking after her 38 year old son's sudden death for help. She found everything from you'll never survive This grief to the idea that there is a time period when grief will be at its strongest but will abate. I want to share this with you because it's the wisest thing I've read on my journey to bring you this episode. So I'm going to be directly quoting from Heidi Bastian's Atlantic article, and if you want to read all of it, I will have it in the show notes.

So I quote, "For most people, after most deaths, grief starts to ease after a few weeks and continues to reduce. From there, there can still be tough times ahead, but in most circumstances, by the time you reach six months, you're unlikely to be in a constant state of severe grief. Although most people will experience grief when they lose someone close to them, they won't be overwhelmed by it. For roughly half the bereaved grief is mild or moderate and then subsides among those who experience high levels of grief at the outset, distress will usually begin to ease in a few weeks or months to, it's not a straight line where each day is better than the one before, but the overall level of suffering does go down over time"

"Some bereaved people thought about 10% according to the research will be in severe grief for six months or longer. The risk of remaining in deep grief for more than a year is higher for those under socioeconomic stress or who experience the loss of a spouse and it's even higher still after the loss of a child or a sudden death via accident, suicide or homicide."

That's kind of what I was saying before. So for example, I worked with someone last year who lost her older child in a plane wreck and her husband was also on that plane  - and he survived. So where does grief get expressed in that family? Often grieve isn't a solo event others lived through. So again, is there a right way to grieve? No, no, no.

Also, to chime in with Ms. Bastian, I have found that grief sort of comes in waves and I've talked about this on the podcast. And you'll wonder and even be afraid what's happening when you get hit by what seems like a stronger wave than ever when your grief had been subsiding. "Oh my, I'm going all the way back to where I was in the first place." That's not my experience with grief. Grief comes in waves and some are stronger than others and then all of a sudden you can get hit by a rogue wave when you get triggered in some way. That's also grief.

But let's talk about when it becomes more severe in penetrating, and I'm gonna go back to Miss Bastian's article. "Adults who face this long-running, even severe distress are experiencing what many clinicians and researchers term prolonged or complicated grief. This increases their chances of having serious mental and physical health problems, including premature death and suicidal thoughts. Even if we don't personally know someone who died within a couple of years of a major loss, we've probably all heard stories of it".

So back to just me talking , there is a new diagnosis called complicated grief and it's still very controversial 'cause it seems to be pathologizing really deep grief and they give it some sort of one year cutoff. If you're still grieving after one year, then you should be given a diagnosis of complicated grief. The Washington Post op-ed argued why set expectations on its pace or texture.

Why pathologize love? Now I'm back to Miss Bastian. Okay, so basically Adam was the name of her son, and I'm gonna go back to this part of her article. "When Adam died, I needed hope that a vibrant life was within my reach. The science showed me that it might be closer than I could even imagine. So I tried to look forward, forward as I did so I held onto a thought about my boy that helped me face a future without him."

And this is incredibly profound. So please listen closely. Ms. Baston: "He had loved me his whole life, that love is precious and it's for keeps. I will not waste it." So what she seems to be saying is she's reached a space or place in her heart and her mind where emotionally dying herself from the pain of losing her son would devalue his love for her.

I remember a woman I worked with many years ago or several years ago, lost her daughter in a tragic accident, completely shocking and a little more than a year after her death, she went to a wedding of one of her daughter's really good friends and they had a picture of her daughter there because she was supposed to have been in the wedding. And she came back into therapy and said something very similar to Ms. Bastian. She said, "I realized I was there because everyone there had loved my daughter and I loved my daughter, and I was there to honor her as hard as it was for her to go." Deciding you're not going to emotionally die along with your your son or your brother, or your mother or your friend is so important. I see this so much. It's a choice to continue living and in so doing, honoring the person who died.

I get a Christmas card every year, in fact, from a family I saw years ago, a couple who'd lost their second child days after his birth.One of them became very angry as his faith was temporarily shattered. The other focused on their living child while also grieving and they had a bit of struggle trying to understand and accept that their separate ways of grieving was okay, that neither had to give up or change their grieving pattern to appease the other.

I've seen this difference in grief often within a couple. It's not wrong, it's normal and natural in their card. I noticed immediately another child that had been born, I'm sure they still grieve the child that didn't live, but it doesn't seem to be stopping them from living and connecting to their life. Now, if you're struggling, then please do seek help. If you're stuck, you can get unstuck, but you may need someone who understands that there's no correct recipe for grief. You simply may need help through compassion and gathering hope.

Listener Email:

Here's our listener email for today. Hi, Dr. Rutherford. I listened to your podcast many times and I love it. I'm 49. I escaped my mom physically to be leaving Israel 23 years ago. I've done extensive work on myself and now I'm in the process of writing a book. Since my dad passed away three years ago also in Israel, I've been re-experiencing feeling wise, returned anxiety, depression, and I'm not as grounded and solid in my place in life. It's all subjective. I have a great family, friends and a husband, but I feel orphaned and guilty for being a bad daughter to my mom, feeling sort of lonely. I'm in California and would love to connect on better help. She didn't realize I couldn't do that. The book writing is obviously triggering, but at the same time I have to do it. I love writing.

So again, this was another message that was sent to me on my email, askdrmargaret@drmargaretrutherford.com and I  invite you to do so. But as I read this, the first analogy that came to mind as this listener was talking about how writing a book, I'm assuming about her struggles as a child in Israel is very triggering for her. Of course it is often when people tell me they don't want to journal, but I might be suggesting it. What they say is, "I don't know what it'll be like to actually see things in black and white." Or I also hear, "What if someone finds it?"

The first question I answer by saying they're absolutely correct. It's often difficult to see your feelings on paper to write down the painful experiences you had. It brings them much more to the surface. You bet it's hard. Here's the analogy I've used. So if your memories are held in a big iron soup pod on the stove and they've been simmering very, very slowly for years with the top on, so slowly they've barely even created any steam, but now you're opening the lid and you might get a huge cloud of steam that reflects those experiences and you have a sudden painful reaction, but you leave the lid off and the puddle settle down again, right?

It'll go back to a simmer. In fact, you might not be able to smell anything at all when you got a huge whiff when you first opened the pot. But what if you continue to stir the pot with every one of those stirs some of the smells of your past, the emotions and memories that belong to what happened will become stronger. Therapy's almost always about stirring the pot, talking with friends, however you communicated. However you begin to reveal yourself is stirring the pot and journaling, or certainly writing a book is also doing the same thing.

But there's one other factor. The death of her father and she doesn't describe their relationship, just says he was also in Israel. But that death may be very symbolically reminding her of the many losses she's experienced, maybe her dad's voice helped her feel that she'd done what she needed to do to protect herself from her mom. Maybe she's simply grieving that her dad is also gone. I'm not sure, but all of this sounds normal to me. Given the circumstance, estranging yourself from a parent or a sibling due to the damaging impact they had on you. When that estrangement is about self-protection, it's complicated. It can be a relief in many ways, but it's very sad as well. I hope this listener goes to better help or a local therapist to get some of the feedback that she seems to need.

Outro:

Once again, thank you for being here. I wanna remind you we're doing a little giveaway. If you'll leave a review, an actual written review on Apple Podcasts, then I'm gonna choose two of those reviewers to get a book. Marriage is Not for Chickens, and what I'm gonna do, I realize that many of you probably don't even know what I'm talking about. So in a YGTG coming up in just a couple of days, I'll actually read the book to you. It takes about maybe two and a half minutes , it's a little book meant to be a gift or a little anniversary, something special present or a getting married present. And I know we have a lot of following winter weddings coming up, or like I say, just anniversaries. It's a fun little gift. My communications manager, Christine Mathias, who's also this incredible photographer, she and I did it and she did a lot of the pictures and certainly did a lot of the framing of those.

And I had a friend from way long ago also contribute to the photography. But the post itself, actually when it was in the Huffington Post, it earned 200,000 views and 50,000 shares. And of course, I didn't get invited on Good Morning America or , any of those. I guess if you're writing about something happy, that doesn't happen, but I'm gonna give away two copies to two people who leave written reviews for the month of September. So have at it.

Let me know what you think about SelfWork, whether that's to say, oh, I wish you didn't do this so much, or you know, whatever I really need and want your feedback. Thanks so much and subscribe. Get onto my new website at drmargaretruthford.com. Look around. It's a lot of fun and if you subscribe there, then you'll get my weekly newsletter. That's it, I promise. But it has some interesting things that I'm doing or ideas I have things that you could be a part of on my Facebook page, that's facebook.com/groups/ self-work. Sometimes we get together for discussions, that kind of thing. But all in all, thank you for being here today. Please take very good care of you, of that family you love, and friends that you love, and your community. I'm Dr. Margaret and this has been SelfWork.

 

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