Wednesday, January 25, 2012

Chronic Sorrow III: 12 Ways to Live More Comfortably With CS

Welcome to the last in a series of three posts on Chronic Sorrow.

While I don't believe that Chronic Sorrow (CS) can be cured, aspects of it can be healed and we can learn to live more comfortably in its presence. I will share some strategies here that have worked for me and for others in my workshops, hoping that some of you will do the same. The more we share our positive experiences, the more comfortable we can all become.

I do have one caveat though. CS is such a complex and individual experience that what eases life for one will not necessarily work for another. So, please do pick and choose the ideas that feel right for you and adapt them to fit your needs.

1. Acknowledge the natural sorrow that comes with your life situation and treat yourself with all the compassion and care you would a grieving friend.
2.  Tell your family and friends about CS so they can have realistic expectations about your sadness and their ability to "fix it". Also, let them know what helps you most when you're grieving.  (Personality type and other factors make a difference to what we might find helpful.)
3.  Form a support team of two or three trusted people whom you can contact 24/7 for emotional and practical support if your grief or trauma symptoms are intense. (Discuss boundaries around late night calls.) Post their phone numbers by your landline and on your cell and carry their email addresses with you. You may use the individuals on your team rarely, but knowing that they're available can make all the difference.
4.  Anticipate predictable grief and trauma stress points and arrange the option of extra support in advance. It is often the days prior to an anniversary date, medical procedure, assessment, or family celebration that are hardest so call your supporters several days ahead with a heads up.
 5.  Remember that you may have trouble thinking clearly or concentrating when the grief is intense so be particularly careful if you're driving, operating machinery, giving medications or treatments, or making important decisions. 
Write down important things in a small notebook so you can remember them. (Where did I put the insurance numbers? Who do I call about respite? Is it time for a physical? ...). Put a hook in the wall and place your keys there every time you enter the house. Never let your gas tank get below 1/4 full. Place a large calendar on the wall by the phone for everyone's appointment and activity times. 
6.  Exercise regularly to reduce stress and to increase endorphin levels. A daily walk in the fresh air is one of the best gifts you can give yourself, even if it's only around a tree in the garden.
7.  Spend time quietly in nature whether in your back garden, at a nearby park or walking in the woods. Allow the changing rhythms of the seasons to give you a message of hope for better hours or days ahead.
8.  Consider seeing a therapist who will companion you through the CS - not because you are "sick" and in need of "treatment", but because therapy will afford you an hour of time to focus entirely on yourself  with someone who will not be personally affected by your grief. (I found, when my husband was ill, that when I attempted to share my sorrow with family and friends, it often triggered their grief and I ended up comforting them.). 
In my opinion, when looking for a therapist, people with CS are well served by someone whose basic orientation is one of parity and companioning; who understands CS (or is willing to learn about it); who has an eclectic theoretical background and experience in grief work, trauma work, and, if possible, bodywork; who is flexible, compassionate and empathic and who can allow the client to determine his or her own goals.
9.  Find safe and personally congruent ways to express the sadness.  CS is a complex, and often complicated, experience that can carry intense feelings - emotions that sometimes seem overwhelming if felt and expressed all at once, without regulation or pacing. 
Some people have had the opportunity to learn healthy ways to self-regulate strong emotions. Others haven't. If you are one of the ones who hasn't, a good grief and trauma therapist, especially one who offers both talk therapy and bodywork such as Somatic Experiencing or Sensorimotor Psychotherapy, can teach you those skills.
Once you know how to regulate and, thus feel safe with, your feelings, choose ways of expressing the sadness (and other emotions) that fit best for you - writing a journal, talking with your loved one or a friend or therapist, painting, poetry, music, dance, prayer. The list is endless.
Sometimes services designed to help us grieve can exacerbate the grief instead. So, if you attend caregiver workshops or retreats, participate only in exercises that feel structured and safe. ie those that approach only a small piece of your loss at a time and that leave you feeling less anxious rather than more.
10. Cry if you want to.  In North America, we live in a culture that gives us mixed messages about what to do with our tears. The self-help movement tells us to "feel, feel, feel" and yet many social settings and cultural traditions tell us to hold our tears until we can cry alone - or to be stoic and not cry at all. 
As caregivers with CS, we need to be able to chose what to do with our tears each time they surface. Sometimes we will want to cry spontaneously and uninhibitedly in the moment, other times we will want to wait until we are alone, yet other times we will choose to use busyness as a distraction so that we won't cry at all. There will even be days when our chests are bursting with unshed tears and, perversely, we'll find that we can't cry.
There is no single "right" answer to the question of crying. Do what feels right at the time. And if you find you can't cry and want to, try using a sad movie, poem or music that has made you cry in the past, to trigger your tears. (I used the movies, Truly, Madly, Deeply; Shadowlands; and A Rumour of Angels, several times over the years to trigger my own tears and ease the tightness in my chest.)   
11. Try writing a gratitude journal. Writing a gratitude journal, (ie writing down 5 things every night for which you've been grateful), will not take the sorrow away but it will help to balance the sadness and, slowly, to balance your perspective.
There is a double "giftedness" in writing a gratitude journal - first, a change in outlook, and secondly, after the care-recipient's death, a recorded history and legacy of many of the small, positive moments in your life with your loved one.  
12. Nurture your spirituality.  (Here, I define spirituality as one's relatedness to oneself, to others, to the world and universe, and to one's Higher Power.)
If possible, carve out daily time for quiet and stillness; pray or meditate regularly according to your personal practice; use this illness or injury as a time to learn about receiving, making meaning, forgiveness, acceptance, trust, equanimity, gratitude, compassion, peace, grace, hope; discuss the difficult existential issues that arise in care-giving with a wise elder, trusted spiritual leader, or therapist; find ways to tell your story to yourself and others; read or listen to material that nurtures and inspires you; live in the present as much as you can, drawing wisdom from the past and hope from the future.
This short list is just a beginning. We would all like to know what has worked for you as you've learned to live more comfortably with CS. Would you take a moment to share your discoveries with us?

If you would like to learn more about Chronic Sorrow:
1.  Read Susan Roos' book, Chronic Sorrow: A Living Loss  (This is a psychotherapy textbook and a little dense, but well written by someone who understands CS both personally and professionally.)
2.  Read the research of the Nursing Consortium for Research on Chronic Sorrow. 
3.  Call or email me to inquire about booking a CS talk, workshop, or retreat:  
       Jan Spilman at (604) 297 0609 or


1 comment:

toni said...

thank you,i can t wait to try these techniques.....