Friday, June 13, 2008

Navigating the River of Grief

We recently featured a blog entry about Ann Hood’s new book “Comfort.” MITSS Support Team Member, Erin O’Donnell, writes about the connection of grief to the work that we do at MITSS:

Feelings are much like waves, we can't stop them from coming but we can choose which one to surf. ~Jonatan Mårtensson

The walls we build around us to keep sadness out also keeps out the joy. ~Jim Rohn

To those of you who have lost a friend or family member to a medical error, the fact that a guest blogger on this site suggested a book about the raw emotions of grief might make complete sense. However, as we discuss in our Patient and Family Groups, grief and loss touch more than those that can say “This is the person I lost. Their name is ______.” Sometimes after an event, there are things much harder to name that are also lost and deserve to be grieved. Without trying to over generalize, many losses can fall into the following description:

-We have an idea about the way the world is and will be and the way that we will be in the world.

-Something happens and our idea won’t work out that way anymore.

-We have new knowledge that the world isn’t the way we thought it was and we may grieve the loss of our old idea, our old world, our old way of being in that world.

-We develop a new idea about the way the world is and will be and the way that we will be in the world, incorporating our new knowledge and grieving feelings.

Is it the fantasy of a birth that would be joyous and filled with happy memories and did not turn out that way that must be grieved, even if all people involved are healthy now? Is there a disability or a loss of health for a short or extended period of time that has created a longing for how life was supposed to be? For many people, the loss of trust in the healthcare profession after an event can be very jarring and disruptive, particularly when re-engaging in that system is important to our ongoing health. The emotional process that occurs after an event can disrupt the entire support system of friends and family, so perhaps lost were moments of celebrating holidays or everyday moments together as they used to be. The list of what can be felt as a loss feels infinite, because it depends on each person’s experience. Therefore, it is important to ask: What was lost?

When recognizing what was lost, it is also important to recognize: What is left? Be generous when answering this question. You may be surprised by how much is left if you allow yourself to let them in as positives in your life. Brainstorm with loved ones if you need to.

Although I haven’t read Hood’s book, “Comfort,” yet, the LA Times reviewer referred to it as the “anticlosure book.” The reviewer also added, “good riddance to a dumb idea,” in reference to the concept of closure after a loss. The description of this book certainly sounds like it is a RAW look at the grief process, which can be very validating. This may be useful to some people and may be too much emotion for others. However, it is true that those experiencing grief tend not to identify well with the concept of “closure.” Why? Because a loss is different than something lost. Something lost can be found again and feels resolved. A loss is permanent and can feel like losing a part of the self, which is not so easily resolvable.

So, what do we do with that loss? Well, there are lots of possibilities, and a blog cannot adequately address them all. However, one option is to try to find meaning in the loss that can serve your new ideas of the future. As in the process described above, when working toward figuring out how the world looks now and how you fit in it, you can choose how you plan to fit the loss into your new worldview so that if feels like it is doing honor to you and the loss. Viktor Frankl’s book, “Man’s Search for Meaning,” may be helpful to those interesting in venturing along this path.

There is no right or wrong way to grieve or feel loss. It is a common experience to all human beings, and it is very common among those touched by an adverse medical event. The way we express grief does become a problem when in interferes with our ability to function in the world (i.e. difficulty at work, struggling with relationships). During those times, it may be helpful to reach out for extra support. Because although grief is perhaps the most common of all human experiences, the path to rebuilding life is not always clear or easy to do without extra support.

Perhaps the most useful description of the grief process was told to me once by Kathleen Gilbert, PhD of Indiana University. She does grief research, including with parents who lost their child due to miscarriage. She said that once a man described it to her this way (quoted from memory):

Grief is like falling into a river.
Once you’re in it, you are in it and you never get out of it.
The river has rapids, whirlpools and mostly calm waters.
You can be floating along in the calm and suddenly be taken under by a whirlpool and feel like you’re drowning.
The next moment the water may be calm again or maybe you hit a rapid.

It is important to remember that, although you may never completely lose the feeling of the loss, the grief will come upon calm waters again.

Erin O’Donnell
MITSS Support Team Member
Doctoral Student- Massachusetts School of Professional Psychology


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