The Paradox of Grief and Gratitude ...

Wherever there's change, there's loss

and wherever there's loss, there's grief.

Bill Bridges

Hello, Everyone,

I have used the quotation above often in workshops and writings and here it is once again. Appropriate for the times, I think ... 

So much has changed in recent months and these changes have brought with them loss and grief in abundance, especially for family caregivers already coping with chronic sorrow and helping professionals carrying years of cumulative grief.

Since the pandemic has taken hold,  family caregivers have lost already-scarce freedoms, resources and supports -  the coffee shops that once provided a brief haven at the end of a morning's respite, the familiar care aides who knew the needs of an ill loved one and didn't require training each time they arrived, the day programs that offered respite as well as support and advice, the volunteers who helped with transportation or yard work or exercise regimes or meals, the warmth and encouragement of a simple hug. Some caregivers have had the worst of anticipatory griefs - standing by as loved ones with worsening COVID symptoms were transferred to acute care facilities, perhaps never to be seen again.

Healthcare professionals have also carried the weight of grief. They've grieved the loss of patients they had hoped to save, relinquished long-held standards of care and infection control, worked without essential equipment, given up contact with their own families, forsaken any semblance of a balanced personal life and mourned the loss of cherished co-workers and friends.

And then, together, we've felt the collective grief of watching as our systems of work, healthcare, education, transportation and economics wavered under the weight of the virus. The tangible losses of unemployment, closed churches and mosques and food insecurity have been multiplied by the broader intangible losses of predictability, control, justice and our assumptions that we could protect the weak and the vulnerable.

This COVID-19 grief is natural and expectable and it will come in waves for a long time after the losses cease. Grief is the way we heal from broken attachments - and it happens automatically provided nothing gets in its way. Grief is a turning inward to reflect, to feel, to recalibrate. There are resources to support this highly individual healing process and we will explore some of them next time.

Paradoxically, the losses stemming from the COVID virus, and their attendant grief, are often accompanied by a sense of deep gratitude. There is something about walking at the edge of life that brings authentic blessings into sharp relief - spring blossoms in a time of death, the kindness of nurses holding phones to unite families in their last goodbyes, messages of support and encouragement painted by children on apartment windows, meals left on doorsteps, 7pm clapping and cheers as healthcare workers change shifts, songs that connect the isolated. We can draw upon this natural pairing of grief and gratitude to nurture ourselves during difficult times.

Brother David Steindl-Rast, the Austrian founder of A Network for Grateful Living and a 93 year old survivor of the Nazi occupation, is a beloved teacher of the practice of gratefulness. In a 2016 interview with Krista Tippett, he said,

To open your eyes and know another day - we can't take it for granted. In my youth, we couldn't take it for granted because every night, the bombs fell. There are all sorts of reasons why you (might not) see another day, and you do. And that's a wonderful thing."

His words could apply equally to these days of pandemic.  The practice of gratefulness is not about being grateful for the pandemic, itself, nor for the numbing pain and despair of these times. Nor is it about avoiding or minimizing our sadness, anger, fear and confusion.  Rather, a gratefulness practice offers the opportunity to experience more than one feeling, in full, at the same time - to know gratitude at the same moment that your heart is breaking with grief. To know sorrow and joy in the same breath.

A gratefulness practice allows us a pause to heal, grow and reconnect with ourselves, others and what or whomever we hold sacred. It doesn't take away our grief but it does help to balance it. So, when you wake in the morning or before you go to bed at night, take some time to think of - or,  better yet, write down - the things for which you're grateful. Some days there will be a long list and other days, as gratitude writer, Sara Breathnacht, says, the only thing you'll be grateful for is that the day is over. Either way, recording your gratefulness will not only help balance your grief in the moment, it will provide a wealth of positive memories from which to draw strength in the future.

Keep well, everyone! I'm grateful for all of you!

A New Workshop: Chronic Sorrow: The Recurring Grief of Family Caregivers ...

Sometimes you just need a good cry in the shower.

Anonymous

Hi Everyone!

I'm excited to announce the launch of a new Caregiver Wellness Community Workshop -  Chronic Sorrow: The Recurring Grief of Family Caregivers.  It will be held on Saturday May 30th  from 9-4pm (registration at 8:30) at the Granville Island Hotel in Vancouver, BC. The tuition is $210 (includes handouts, continental breakfast, light lunch, breaks and GST).  Brochures with registration forms are available at caregiverwellness@shaw.ca.

Family caregivers grieve many losses and they tend to grieve alone - in the shower, in the car, in the laundry room, on solitary walks. You grieve because your loved one's serious, permanent illness or injury has changed everything. And with each change comes loss and with each loss comes grief.

Studies, so far, suggest that up to 80% of family caregivers experience recurring episodes of variably intense grief continuing from the time of their loved one's diagnosis until that loved one's death. This grief does not necessarily diminish over time like grief after death. Rather, it can increase in intensity and frequency as time goes on. This caregiver grief is called Chronic Sorrow.  (Chronic Sorrow is also experienced by people who have a serious permanent medical condition, but in a slightly different way.)

Chronic Sorrow is a normal response to loss without a foreseeable end. It is not depression or complicated grief though it is sometimes misdiagnosed as such. It includes not only feelings of sadness but all the emotions of grief - anger, guilt, envy, anxiety, fear, loneliness and others. These grief emotions are triggered whenever something reminds you of the discrepancy between how things are and how they "could" or "should" have been had the illness or injury not occurred.

Chronic Sorrow  cannot be "cured" but you can learn to live with it more comfortably and that's what this workshop is all about. It had a "test run" with the family caregivers at the Children's Organ Transplant Society and the Starlight Foundation last spring to very positive reviews and now it's here for you - anyone who provides physical or emotional support to a person with a serious, permanent medical condition, physical or mental.

Space is limited so please register early to avoid disappointment. The registration deadline is May 15th.  

If you have questions, you can contact Jan at caregiverwellness@shaw.ca or (604) 297 0609.

Hope to see you there!



*** I'm sad and disappointed to say that all Caregiver Wellness workshops are postponed until at least the fall due to COVID-19. ***

Enduring Somatic Threat ...

Once you ... put the pieces back together, 

even though you may look intact, 

you (are) never quite the same

as you were before ...

Jodi Picoult

Hello, Everyone,

Over the summer as I was writing an article on Chronic Sorrow, I tripped over some interesting new medical research on a proposed subset of posttraumatic stress called enduring somatic threat (EST). Have you heard of it? Well, to be honest, neither had I -  though in retrospect I recognize aspects of it in my husband's seven year journey with heart failure.

Physicians and psychologists in the cardiovascular field have been studying the 12 - 25% of people who have posttraumatic stress disorder (PTSD) responses after life-threatening medical events such as heart attacks, unstable angina, TIA's and strokes. The response they describe is similar to traditional posttraumatic stress disorder but is said differ from it in four ways:

1. The initiating event and continuing source of threat come from within the body rather than the external environment so there is nowhere to go to escape the threat. 

2.  The person's threat-oriented thoughts and intrusions are focused more on the dangers of the present and future than memories of a past event. Because the underlying illness persists, there is constant concern regarding a present or future recurrence of the life-threatening event or something similar. 

3.  Avoidance behaviours focus on reducing reminders of current and future cardiovascular risk rather than triggers of a past event. (eg Patients may avoid prevention medications and physical activity because they are reminders of the continuing threat.)

4.  Hyperarousal behaviours and their consequences are also different from traditional PTS. People become hyper-aware of internal body sensations vs external environmental cues (fear becomes velcroed to an increased heart rate, irregular heartbeat, breathlessness, the first stirrings of chest pressure or pain, slurring of speech, loss of balance, numbness, tingling etc).

While I'm not completely sure that all the above distinctions are true distinctions - perhaps it's more a matter of both-and than either-or when it comes to past and present/future somatic threat - it will be interesting to see how this research progresses and whether it begins to explain some of the differences we see between "patient" and family caregiver manifestations of Chronic Sorrow.

I think it is wonderful that medical and psychologically-oriented folk are working together to explore the traumatic impact of life-threatening events on their patients and families. I am hopeful that they will include previous research on Chronic Sorrow and Somatic Experiencing in their explorations and models so that grief and trauma can be addressed together (they're usually entwined in serious chronic illness) and that somatic treatments will be considered for this somatic distress.

If you are interested in reading some scholarly articles about enduring somatic threat, perhaps begin with the articles below:

Edmondson, Donald E.  An enduring somatic threat model of posttraumatic stress disorder due to acute life-threatening medical events. Soc Personal Psychol Compass. 2014 Mar 5; 8(3): 118-134.

Edmondson, DE et al. A challenge for psychocardiology: Addressing the causes and consequences patients' perceptions of enduring somatic threat.  American Psychologist. 2018 Vol. 73, No 9, 1160-1171.

A Word About Words: Chronic Sorrow ...

Where there's change there's loss

and where there's loss there's grief.

Bill Bridges

Hi Everyone,

I've been writing about the grief of family caregivers this weekend and I was struck by how many terms now exist to describe this experience. The professional writings about caregiver grief are fraught with confusion and contradiction due to the increasing number of overlapping terms and concepts.  This differing terminology arises from different professional fields, the study of different medical conditions, research in different nations and cultures, and studies from different times in history. I'll share a few of them with you here:

1.  Anticipatory Grief is the earliest of the overlapping concepts applied to the natural and expectable grief of family caregivers.  It was coined by German psychiatrist, Erich Lindemann, in 1944, to describe grief we experience before a loss actually occurs.  Later, Therese Rando expanded the concept, defining it as:

The mourning, coping, interaction, planning and psychological reorganization that are stimulated and begun, in part, in response to the impending loss of a loved one and the recognition of associated losses in the past, present and future.  (2000, p29)

Many writers assume that anticipatory grief is synonymous with caregiver grief.  However, in my personal and professional experience, anticipatory grief comprises only a portion of a family caregiver's heartbreak. To a great extent, caregiver grief also includes responses to current loss.  Workshop participants tell me that while the pain associated with the anticipated death of a loved one is certainly part of their reality, their greatest source of sorrow is the daily losses associated with current changes and adaptations.

2.  Chronic Sorrow (CS) is the second term used to describe caregiver grief. It first appeared in the literature in 1962 in an article written by American social worker and advocate for families of developmentally delayed children, Simon Olshansky. At the time, family caregivers were seen as being unaccepting of their children's diagnoses, stuck in their grief and, therefore, difficult to deal with. Olshansky offered  another viewpoint, saying that these parents were suffering from  expectable, continuing, episodes of grief that flowed from the losses occurring across their children's lifespans. He pushed for caregiver support rather than medical attitudes of pathologizing and criticism.

After an initial flush of interest in Olshansky's ideas, CS disappeared from the literature until the mid-1990's when the Nursing Consortium for Research on Chronic Sorrow published several studies confirming the concept and studying its characteristics. Later, in 2002, family caregiver and psychologist, Susan Roos, PhD, gathered the research to date and combined it with her considerable personal and professional experience to publish the first (and only) psychotherapy textbook on CS. Her book included this comprehensive definition of caregiver grief, one which includes both the grief of people with serious, permanent, medical conditions and that of those who love them:

Chronic sorrow is a set of pervasive, profound, continuing and recurring grief responses resulting from the loss or absence of crucial aspects of oneself (self-loss) and another living person (other-loss) to whom there is a deep attachment. (2000, p29

At its core, CS is the grief resulting from resulting from an aching discrepancy between life as it is and life as it could or should have been had the illness or injury not occurred.

Since 2002, multiple research articles have continued to be published.


3.  Ambiguous Loss is the third concept to describe the unresolved grief of family caregivers It appeared in the literature in 1999, much later than Chronic Sorrow. The notion was developed by educator and researcher, Pauline Boss, PhD, with little or no knowledge of the prior CS research.  Arising from the study of families whose soldier relatives were missing in action, and then applied to the dementia and adoption fields, it describes the losses and grief related to caring for people who are physically present but psychologically absent or psychologically present but physically absent. Thus, the reality of the loss remains ambiguous or uncertain.

(I see this and the other concepts described here as subsets of Chronic Sorrow.)


4.   Non-finite Loss, our fourth concept, was developed by Bruce and Schultz in 2001 to describe the lifetime of continuous and insidious loss and grief experienced by parents of developmentally delayed children.  They focused attention on the parents' gradual discovery of the impact of illness or disability with the accompanying loss of hopes, dreams and expectations.  This term has also been applied to family caregivers of those with degenerative diseases such as MS, motor neurone disease and dementia. It has been used to describe the reactions of families with non-medical losses such as those with a relative waiting on death row as well.


5.  Pre-death Grief  is the fifth and final term to be considered here.  It was coined in 2014 to provide a standardized  definition of caregiver grief upon which to base professional theories and research questions.  Pre-death grief is defined as the caregiver's emotional and physical response to the perceived losses of a valued care recipient.


While facilitating workshops on caregiver grief, I tend to use the term, Chronic Sorrow. Why? Because, while the other terms all reflect important aspects of caregiver grief and there are logical reasons for their presence in the literature, they are all in some way incomplete. CS, on the other hand, has a specific, comprehensive definition that includes the grief of both patient and caregiver, it offers the clearest demarkation between pre and post-death grief, it has a long medically and psychologically-oriented research history, and, most importantly, it has the most immediate and profound emotional resonance with family caregivers.

When I ask workshop participants which term they prefer in describing their grief, they are emphatic, and usually unanimous, in choosing Chronic Sorrow.  It most accurately and empathically communicates their experience and that, it seems to me, is the single most important reason for choosing any terminology.

I'm hoping to offer a community workshop on Chronic Sorrow for family caregivers in Vancouver again next spring. If you think you might be interested in attending, just subscribe to the mailing list in the left hand column of the website and you will automatically receive a registration brochure.

Compassion Fatigue and Chronic Sorrow as Soul Injuries

All it takes is a beautiful fake smile 

to hide an injured soul;
they will never notice

how broken you really are.

Robin Williams

Hello, Everyone,

Lately I've been noticing that some of the people in the CF and CS workshops nod in immediate recognition when I describe full-blown compassion fatigue and chronic sorrow as soul injuries. They know, intuitively, that the suffering they experience is deeper and more pervasive than the emotional pain described and addressed in some self-care workshops. It is a relief for these folks to have someone acknowledge the severity of their pain. This acknowledgement is often a first step toward releasing shame and opening the pathway to healing.

Soul injuries are wounds of our souls or essence, the loss of our sense of inner goodness, beauty and vitality stemming from trauma, unattended loss, burnout and the guilt and shame of our own actions or omissions.

Soul injury symptoms are described by Opus Peace as the familiar signs of postraumatic stress plus a defense-penetrating breach in the integrity our deepest selves. They often include:

1.  A haunting sense of being defective or tainted,

2.  A sense of betrayal by one's self, others, an organization, religion or God/Higher Power, and/or

3.  A sense of emptiness arising from disconnection from the part of ourselves carrying the pain.

Some of us have carried these injuries from childhood and others have experienced them later in life or through longterm exposure to the trauma and suffering of those we serve.

While our souls or essence will never be killed by our work, we can become separated from our original strength, truth, wisdom and compassion. We separate ourselves from our souls each time we cover up, numb out or run away from our truth and that separation eventually generates it's own symptoms. On the other hand, when we own our truth (including its pain) in gentle respectful ways, our souls can expand to hold and heal our wounds.

The healing of a soul injury entails addressing soul issues. Not only must we grieve unattended losses and re-regulate traumatized nervous systems, we must also forgive and make a home for the parts of ourselves we have denied and split off due to guilt and shame.  Then, we need to develop and nurture a life of the spirit - deeply personal and meaningful beliefs, teachings, ceremonies and rituals that will provide a strong foundation for building resilience.

As Opus Peace says, we all need a class on:

...how to open our hearts to our losing and failing, paradoxically becoming whole in the process. Re-owning and then re-homing pieces of self (often hidden behind facades or exiled into unconsciousness)  can precipitate healing. Telling stories of our lostness (without the distorting illusion of how we wish our lives to be) is the first step toward freedom. Hearing other peoples stories en-courages us to liberate our own.

So as we become deeply honest with ourselves, at least one other person and Whom or Whatever Benevolence we believe in, trauma can be healed, losses grieved, guilt atoned, forgiveness accepted, shame dispelled and a future, strengthened and brightened by hope and small "s" spirituality, explored.



*** For those who've been asking, the next Caring On Empty Workshop for Helping Professionals will be held at The Granville Island Hotel on Monday May 7th from 9-4.  Brochures with registration forms are available at caregiverwellness@shaw.ca.   Please tell your friends and colleagues!



Photo from the Opus Peace website.

The Wild Edge of Sorrow ...

There is some strange intimacy between grief and aliveness, some sacred exchange between what seems unbearable

and what is most exquisitely alive. Through this,

I have come to have a lasting faith in grief.

Francis Weller

The Wild Edge of Sorrow

Hello, Everyone,

I began the post below earlier last month but was interrupted and forgot to hit the "publish" button so here it is now, sans the snow! .....

Here in Vancouver, we are trapped in the wilds of winter with more snow on the ground, in the trees, on the roads and in the air in this past week than we usually see in a year! The whole world seems to be held in muted abeyance, hibernating as it waits for its natural rhythms to return. It's a time to bury yourself in a cozy blanket with a good book and that's just what I've been doing all weekend.

Having lost four dear ones since mid-December (five, if we count my sister's Maggie-dog, a lovely Bernese Mountain Dog who captured all our hearts), witnessed the devastation of so many  lovely trees at the lake during this year's unusual snowfalls, been stunned by the deaths of six innocent Muslims at prayer in Quebec City and experienced profound sorrow at the hateful rhetoric arising from so many parts of our world, I have been reading a new-to-me book on grief. I'd like to share some of its goodness with you this morning.

Francis Weller's book, entitled The Wild Edge of Sorrow: Rituals of Renewal and the Sacred Work of Grief, is one of the better volumes on grief I've had the pleasure to read. Beautifully written, it covers five categories of loss which Weller says form five gateways to grief - 

1.  The gateway of illness and death

2.  The gateway of the parts of our selves that didn't receive love -  parts that were then lost  through being wrapped in shame, banished and marked unworthy

3.  The gateway of the world's sorrows -  the loss of care for the earth and the devastated state of the earth and its creatures 

4.  The gateway of what we expected and did not receive -  the loss of the welcome, engagement, touch and reflection we are all hardwired to expect at birth and throughout our lives but may not have received because we weren't raised by a village that could meet multiple needs or because

5.  The gateway of ancestral grief - the losses of our ancestors, often unknown or unacknowledged, and the secondary losses arising from the ways in which they coped with their pain (violence, alcoholism, eating disorders, emotional abuse and neglect, rejection of culture etc), all still carried within our bodies

Weller spends a good deal of time talking about the importance of ritual, a form of support readily available to the bereaved but often missing for people with disenfranchised grief such as chronic sorrow. Because this grief response is not mentioned specifically in the book, the volume also lacks the needed cautions reminding family caregivers to avoid doing deep grief work around more than one loss at one time so as not to become overwhelmed.

I found this book a poetic read with exquisitely evocative language. It provides a needed reminder for all of us to acknowledge and work with our losses so they don't have a continuing negative impact on our selves and our world and so that our personal aliveness can be kindled through the transformation of our grief. Weller's writing is empathic and resonates with the grief of the reader and, although its  recommended group work for healing grief is not a process that appeals to my introverted soul, it obviously appeals to and helps many others. I would recommend this book to anyone interested in learning more about ritual and the healing of grief.

A second book I've found supportive and soothing in these days of sadness is Jan Richardson's new book, The Cure for Sorrow: A Book of Blessings for Times of Grief. While written from the specific perspective of a United Methodist minister and new widow in the US, this book touches on universal themes of loss, grief and transformation and invites us to "know the tenacity of hope and to recognize the presence of love which ... is 'sorrow's most lasting cure'". Here is one of Jan's new blessings, one which I think applies to caregivers as much as to the bereaved:


The Blessing You Should Not Tell Me

Do not tell me
there will be a blessing
in the breaking,
that it will ever
be a grace
to wake into this life
so altered,
this world
so without.

Do not tell me
of the blessing
that will come
in absence.

Do not tell me
that what does not
kill me
will make me strong
or that God will not
send me more than I
can bear.

Do not tell me
this will make me
more compassionate,
more loving,
more holy.

Do not tell me
this will make me
more grateful for what
I had.

Do not tell me
I was lucky.

Do not even tell me
there will be a blessing.

Give me instead
the blessing
of breathing with me.

Give me instead
the blessing of sitting with me
when you cannot think
of what to say.

Give me instead
the blessing
of asking about him -
how we met
or what I loved most about the life
we have shared;
ask for a story
or tell me one
because a story is, finally,
the only place on earth
he lives now.

If you could know
what grace lives
in such a blessing,
you would never cease
to offer it.

If you could glimpse
the solace and sweetness
that abide there,
you would never wonder
if there was a blessing
you could give
that would be better
than this -
the blessing of your own heart
opened and beating
with mine.


Blessings to all of you who grieve today.

Unfinished Song ...

Hello, everyone! I went to a Saturday afternoon matinee at the Fifth Avenue Cinema in Vancouver this past weekend and saw a wonderful movie I'd like to recommend to you. If you are a family caregiver or a helping professional wishing to understand the caregiving experience a little better, this is a movie to see - though you'll want to take along a box of kleenex if you're anything like me and my friend, Sandra.

Unfinished Song (or A Song for Marion, depending on where you live) is a 93 minute British - German production starring British actors, Vanessa Redgrave and Terence Stamp. Set in a dreary English council estate (public housing), the story describes the experience of a family dealing with the end-of-life. Marion has cancer. She is also a member of a senior's singing group called the OAP'z (Old Age Pensioners - with a z rather than an s for added pizzaz!) As she realizes that the only treatment left to her is "going home and eating all the chips and ice-cream she wants", she becomes motivated to join her group in a national singing competition.

Arthur, Marion's husband and primary caregiver, and a man who shields himself from all but her through gruff anger and withdrawal, loves her deeply and is terrified by the possibility of losing her. He worries that all the singing practices will be too much for her and he tries to convince her to stay home. (A familiar conflict among so many caregivers and care recipients.)

In a parallel storyline, we see that Arthur's earlier life experiences and British stoic mentality, have led to a parenting style that has both hurt and alienated his son, James. James, in turn, is doing all in his power to raise his own daughter with a more open heart. The interventions of the young singing group leader, Elizabeth, eventually create space for healing and moving on. I won't spoil the film by telling you the rest of the story - I hope you will go and see it for yourselves.

What I will say is that the main characters are impeccably acted by Redgrave and Stamp, to say nothing of the quality of acting by other three main characters. Terence Stamp manages to portray the anxious, raw, irritability of caregiving, and it's underlying chronic sorrow, to perfection. Some of his conversations with Marion could have been mine with my own husband, so authentic were they. The elegant, articulate and beautiful Vanessa Redgrave risks looking and acting the part of an elderly woman in the late stages of cancer and she does it understatedly and superbly.

I would be remiss if I didn't also mention the energy, humour and wonderful voices of the seniors in tie-dyed T-shirts, singing choral arrangements of Metallica, who make up Marion's singing cohort. You'll find yourself smiling all over your face as you watch them sing and catch their zest for life.

While the plot is a little predictable, Unfinished Song is a rich and honest story that Huffington-Post  reviews like this:

Yes, it's a weepy one. But it's also a really good rich tale that builds ideas and deepens characters until the heartstrings snap and you can't help but cry. It's good to feel stuff. And this movie is full of the best sort of feelings.

I guarantee that it won't be long until this lovely movie finds its way into one of my caregivers workshops. Enjoy!

Chronic Sorrow Article ...

I'm too productive to claim to be seriously depressed, and I can feel happy or amused at times, but life just seems wrong. 

Susan Roos, PhD

Chronic Sorrow: A Living Loss 

Hi everyone! I'm pleased to say that the Winter issue of BC's Insights into Clinical Counselling held my first full-length article on Chronic Sorrow, Unending Loss: An Introduction to Chronic Sorrow in Family Caregivers. The emails and phone calls I've received in response to this article have underlined the potency of the information and and the need of family caregivers everywhere to have their unique experience acknowledged and understood.

The article begins:

Introduction

I wish I had known in 1997 the things I know today about chronic sorrow (CS), a distinct, common, but little known grief response affecting people with chronic conditions and those who love them.

Late in the fall of 1997, following a hike in the North Shore mountains, my previously healthy husband developed a life-threatening heart rhythm, the first sign of what would become a seven year journey with heart failure. During those seven years, I coped with many stressors including feedback from family and friends regarding my "depression". Wasn't I over his diagnosis yet? Hadn't it been several years? Why was I still crying? Perhaps I should see the doctor for antidepressants?

Part of me pondered the same questions but another part insisted that I was not depressed. I was too focused and functional to be depressed and my periods of intense sadness, while many, were interspersed with times of genuine happiness, pleasure and gratitude. So, if not depression, what was I experiencing?

It was not until the year after my husband's death that a workshop comment by grief expert, Robert Neimeyer, PhD, led me to the writings of American psychologist Susan Roos, PhD, and through her work, to the Nursing Consortium for Research on Chronic Sorrow (NCRCS). There, I discovered ...