Living With COVID Grief ...

Grief is itself a medicine.

William Cowper

Hello, Everyone,

The COVID season of 2020 has been a season loss and grief - and it's not over yet. Loved ones have become ill and died. Jobs have been lost. Professional aspirations have disappeared at least temporarily. Human connections have been disrupted. Life plans have been altered. And even as society reopens, COVID-related change and loss continue.

As we cautiously begin to leave isolation behind, more losses accumulate. Those few hard-found gifts of COVID - a slower pace, more time with loved ones, reduced commute time, free parking at work, chances to pursue neglected hobbies and activities, giving and receiving more focused and intentional emotional support, opportunities for reflection, the surfacing of deeper values - threaten to drop away as life changes pace once again. 

Grief is also tied up in our imaginings about the future and the possibility of losses to come. We face the distinct possibility of a "second wave" as fall and flu season approach.  Will a loved one become ill as we open further and return to school? Will we become ill ourselves? Will we lose our jobs? This is called anticipatory grief and it adds yet another layer to our sadness, anger, anxiety, fear, guilt and envy.

With all these COVID losses compounded by contextual losses such as economic insecurity and systemic racism around the world, there's more than enough grief to go around. So, the trick is to find the right conditions in which to grieve our losses well. Because grief is so individual, "the right conditions" will differ for each of us but here are a few general practices that might help:

1.  Acknowledge that you've had, and will have, many losses during this COVID season of life.  Every change - positive or negative - brings loss, and grief is our healing response to loss. We grieve automatically, provided nothing gets in the way. Becoming aware of our losses and accepting their presence makes space for our grief, direction and focus to our mourning and provides opportunities for others to support us.

 2.  Pace your grief when you have multiple losses. It can be overwhelming to try to grieve everything at once. Take baby steps. Make space for grief, one small piece at a time. (And know that you may return to the same loss over and over again before it feels integrated.)

If grief begins to feel overwhelming to you, try self-regulation skills like breathing practices, grounding exercises or physical shaking to calm you when you're  "amped up" and anxious or enlivening practices like engaging your five senses, walking meditation, squeezing  your forearms with the opposite hands when you start to feel "shut down" or numb. 

2.  Find a sanctuary where you feel safe and comfortable expressing your grief emotions. If you're able to do it, give your grief feelings freedom to arise spontaneously. But, if you can't because it seems neither safe nor possible, try identifying a sanctuary where you can retreat intentionally to take down your guard and let your inside and outside match. This creates intentional space for your hardwired grief response to do its healing work. 

For some, this sanctuary will be in the arms of a loved one who lives inside your bubble; for others it will be found alone in the car, the shower or in bed at night; and for others still, it will be within a formal ritual or ceremony (in person or online) or out in the beauty of the natural world. What matters is that you feel safe enough to allow your grief to surface for a while.

3. Express your feelings in ways that feel natural and comfortable to you. There is no "right way" to grieve.  And you don't have to cry to prove you've grieved. The fine arts provide many possibilities for expressing grief - story-telling, journalling, writing poetry or letters, listening to or playing evocative music, drumming, dancing, singing, collage, drawing, painting, sculpture, pottery, photography, fibre arts or woodwork. Use avenues of expression that feel natural for you. You don't have to squeeze yourself into someone else's idea of "proper" grief expression.

If your body feels tight with emotion that you want to release but can't, you might try listening to music, watching movies or reading poems that have triggered your tears in the past. They will likely do the same thing again.  (Repeated cycles of Truly Madly Deeply, Shadowlands and A Rumour of Angels helped release my frozen tears through seven years of chronic sorrow and more years of bereavement grief following my husband's death.)

Physical motion can also do much to diffuse pent-up emotion. Walking or running in nature, dancing or engaging in individual sports can all help.

If you are yearning to share your grief with another human being but feel constrained by the  COVID restrictions, try reaching out to loved ones, a therapist, a spiritual advisor or a support group through appropriately secure video meetings like Zoom or Skype, phone calls, texting or social media. Handwritten letters, though seemingly old-fashioned these days, can offer a particularly personal and connected way of sharing your grief.

4.  Create rituals that support and facilitate your grief.  Grief specialist, Alan Wolfelt describes grief rituals as "symbolic activities that help us, together with our families and friends, to express our deepest thoughts and feelings about life's most important events". A ritual doesn't have to be fancy or complicated and it can be experienced individually or in a supportive group.

Examples of grief rituals might be to: 

a.  Have a physically-distanced or Zoom meal where each person brings an item that symbolizes their life before COVID and another that symbolizes life since COVID. Focus discussion on the meaning and feelings attached to each item. Listen respectfully to each person's reality.

b.  Create art in memory of life before COVID and share it and your feelings with others.

c.   Light a candle to hold space for your grief and write a letter to your old life, expressing how much you miss it.

d.   Use ceremonies with sage, incense or fragrant essential oil to cleanse or let go of the old life and open you to the new.

There are as many rituals as there are people - let your imagination go and create what will work best for you. 

However you decide to deal with the changes and loss of COVID-19, try to honour yourself and your losses by making space for the "good medicine" of your grief.

The Problem of Needing to Ask for Help ...

Life doesn't make any sense without

interdependence.

We need each other 

and the sooner we learn that, the better it is for us all.

Erik Erikson

Hello, Everyone - Happy Canada Day!

Today is not only the birthday of our beautiful country, but for me and thousands of others it's the first day of summer holidays. Sadly, this year I'm packing for the cottage with one wing in a sling after catching my feet in the edge of the bedspread as I changed the sheets. Now, having snapped the head off the radius bone in my forearm, the packing process is a little more complicated!

(Yes, I know. I could at least have broken it doing something exciting but I did paint quite a picture as I caught both feet in the spread, flew low across the room, too quickly to save myself, landed and skidded even further across the carpet and then rolled on my back with my legs in the air, stunned and winded.)

After several moments of trying to catch my breath and figure out what had happened, I got up and checked for damage and, realizing that most of my in-town support network were away, called a physician friend half way across the country and together we did an ortho exam on the phone and figured that I'd be black and blue in the morning but that nothing was seriously awry.

Roll on the next morning when I woke to discover that, despite icing, my left elbow was crooked, swollen and exquisitely painful and the closest I could get to touching my nose with my finger was a good foot away. And that led to the first of many uneasy decisions regarding whether and how to ask for help.

Why is asking for help such a big deal ...?? Well, if you're like me, you grew up in a family where independence, strength and self-sufficiency were the expectation and, thus, the norm. "Whining" was nipped in the bud, trying-it-yourself-before-asking-for-help was mandatory and feeling anything from uneasy vulnerability to outright shame accompanied even the most legitimate requests for assistance. Such experiences, encountered both at home and at school, would not have been unfamiliar to anyone growing up in the '50's and '60's in North America.

In her more recent book, Help Is Not a Four Letter Word, author and researcher, Peggy Collins, has published survey results to the question, What frightens us most about asking for help?. The top twelve fears are:

• bothering other people
• rejection / being told no
• looking weak, inadequate, needy or just plain foolish
• someone taking over / surrendering some of my power
• owing other people and having to pay them back
• things not being done the way I would like them to be done
• relying on someone who doesn't come through
• losing the reputation that I can do it all
• not performing like I was raised
• not asking in the right way
• others seeing my mess
• believing my needs are not important enough for others to meet

Perhaps a few of these sound familiar ...?

Ultimately, after this week's fall, I had to face the vulnerability of requesting help before getting almost anything done and I relearned something I learned years ago when people cried after being invited to help with my husband's care; people WANT to help. All they need is the invitation and our willingness to be in the receptive role.

It's a great lesson in humility to recognize and admit that we helpers also need help sometimes - a lesson that most of us need to learn again and again. Interdependence is the goal of healthy relationships, families, organizations, communities and nations. None of us can go it alone. We need each other and, as life coach Heather Plett says, (quoting Christina Baldwin in The Seven Whispers), -

"Ask for what you need and offer what you can." That's what creates the balance, the yin and yang of relationship. Even those who teach this need to be reminded to put it into practice.

So, great bouquets of gratitude to Ted who supported me in the first hour after the fall, my sister Sheila who drove me from pillar to post all week long as I saw medical professionals and prepared to fly to Ontario, my friend Cathy who - as always - empathized and made me laugh, Sandra who provided distraction and Healing Touch, Ginger who took me to the Market for coffee and mystery books, Linda who drove me to church and offered more, and Janet (my Enneagram "six-sister") who worried and planned for me so I could relax! Interdependence is what makes a healthy world go round and I'm so very grateful for that truth this week.

Happy Summer, Everyone!

A Friend Indeed ...

Hello, Everyone,

This morning, I want to say a bit about friendship, having learned of the death of an old and dear friend, Susan (Mitchell) Voth, on the first day of this new year. (My heartfelt condolences to her family and friends.)

I met Susan in 1970 during my urology rotation in nurses' training at St Paul's Hospital in Vancouver.  I was an eighteen year old junior surgical student and she was a relatively new RN from the Maritimes who kept everyone - patients, students, staff and physicians - in stitches much of the time. While she struggled with a learning disability that made her handwriting and spelling atrocious, she had the kind of natural wisdom and intuitive knowing that made her an invaluable partner on nightshift when a patient's condition was going south and the issue hadn't quite declared itself. Her heart was as big as all outdoors and she stayed in touch with many of her patients and families over the years.

Susan and I became fast friends during my training days and were roommates, on and off, over ten years until each of us married. She and her first husband, Al, who was later killed in an airplane accident, moved to the prairies to farm and we eventually lost track of each other. I was happy to have the opportunity to reconnect with her briefly when she visited Vancouver years later after marrying her second farmer husband, Henry.

Susan was a good friend to me and I realize, now, that we understood each other so well because we  shared the effects of our particular childhood trauma - Susan had lost her mother at the age of two and I had experienced significant medical trauma and maternal separation at birth. We had also lived through many years of our fathers' alcoholism. Those shared experiences gave us a natural empathy for each other and our friendship helped fill many gaps from our younger years.

From Susan, I learned to cook, camp, canoe, enjoy a little good scotch, choose a good lobster, like pop music, socialize in large groups (I was very shy), play my guitar in public, drive a car (first a volkswagon beetle, then an MG Midget and finally a volkswagon van that took us 23,000 miles around North America in 1978),  to laugh more and worry less, and even to recognize that I had a spiritual life worth developing (though our paths-of-the-spirit soon diverged). Her family - her Dad, Helen, and siblings, Nancy, Peter and Mary - welcomed me into their homes and offered rich adventures on the ranch in Manitoba; in Cornerbrook, Newfoundland; on the St Stephen, NB - Calais, MA border; and by the sea in St Andrew's, NB, adventures that I would never have had otherwise and will never forget. I owe a debt of gratitude to each of them.

We know from the literature on trauma and social bonds that all human beings need social support to survive and thrive. When we have someone we can trust with our stories and our feelings and from whom we can receive support without judgement, we heal better and faster from the wounds of life.   Susan was one of the first of a large network of valued family and friends who have provided that kind of friendship to me. I am forever grateful.

If you have a friend or friends who have been particular supports to you, why not take some time today to think of them and their value in your life and then, perhaps, pick up the phone or write a note to tell them, specifically, how much they mean to you and why.

If, on the other hand, you're feeling isolated and alone and can't even think of a person you'd call a friend, watch this space next time when we'll look at the process of making friends. (An important skill for those who have never had many friends or whose support networks have shrunk significantly through ongoing care-giving or compassion fatigue.)    

 

Connection ...

... love and intimacy are among the most powerful factors in health and illness, even though these ideas are largely ignored by the medical profession. ... I am not aware of any other factor in medicine - not diet, not smoking, not exercise, not stress, not genetics, not drugs, not surgery - that has a greater impact on our quality of life, incidence of illness, and premature death from all causes.

Dean Ornish, MD

Dean Ornish, an American cardiologist and founder of the Centre for Integrative Medicine in San Francisco, (best known for his use of a very low fat diet to reduce or reverse coronary artery disease), has also spent a number of years studying the effects of love and intimacy - an open heart - on our health and wellness.

In his 1997 book, Love and Survival: The Scientific Basis for the Healing Power of Intimacy, Ornish writes:

The real epidemic in our culture is not only physical heart disease, but also what I call emotional and spiritual heart disease - that is, the profound feelings of loneliness, isolation, alienation, and depression that are so prevalent in our culture with the breakdown of the social structures that used to provide us with a sense of connection and community.

He goes on to say that loneliness and isolation affect our health in several ways:

1.  They increase the likelihood that we may engage in behaviours like smoking and overeating that adversely affect our health and decrease the likelihood that we will make lifestyle choices that are life-enhancing rather than self-destructive. 

2.  They increase the likelihood of disease and premature death from all causes by 200-500 percent or more, independent of behaviours, through different mechanisms, many of which are not fully understood.

3.  They keep us from fully experiencing the joy of everyday life.   

In short, anything that promotes a sense of isolation often leads to illness and suffering. And anything that promotes a sense of love and intimacy, connection and community, is healing.

So, what does this say to us as helpers? It reminds us of the vital importance of creating and sustaining supportive relationships in which we can be ourselves, transparently and authentically. Compassion fatigue, burnout and accumulated grief all cause our hearts to close and we disengage from family and friends, colleagues, and care recipients. Wellness opens our hearts, enabling us to be emotionally aware, to disclose our emotions in a mindful way, to listen carefully to what the other person is feeling, and to acknowledge that person's feelings with empathy, caring and compassion.

It can be difficult, at times, to maintain healthy connections but, as we can see above, its worth making the effort. I remember becoming more and more isolated over the years of caring for my husband. I felt deeply connected to him but had only a few other  relationships that I continued to nurture actively. There just weren't enough hours or energy in the day.

It wasn't until the last three years of his life, when Derrick became confined to bed and I had to organize a rota of friends to stay with him whenever I left the house, that I realized how much I had missed and needed mes amis. As different folks came to the house on Wednesday and Saturday mornings, I went out to do errands and then returned to have a cuppa with whomever was there. Those visits were God-sends. Not only was I able to connect with loved ones, but with loved ones who got our situation because they'd just spend the morning with my husband. We were able to have honest, open-hearted conversations that allowed our care and compassion to flow and it was so good.

So, if you have been too busy, too tired, too scattered, too sad, too irritable or too fed up to connect with your friends for the past while, why not consider giving someone a call and arranging a date for lunch or coffee or a chat on the phone. It's always okay to limit the time from the onset if you're really tired or afraid of getting overwhelmed - "I only have twenty minutes, but I've been missing you and wanted to connect." Choose who you call wisely and you may be surprised to see just how much better you feel after the conversation.

ps  I will be re-connecting with loved ones over Spring Break and the Easter weekend, myself, so I won't be back in the office until Tuesday April 2nd. In the meantime, I wish each of you a very Happy Easter and all the blessings and veriditas of Spring.  Jan

Support Systems...

I'm just back from a week's writing at The House of Bread, a Benedictine Community on Westwood Lake outside Nanaimo, BC. The Sisters of this Community provide many services to the folk of Vancouver Island including the Bethlehem Retreat Center, a wonderful place of peace and stillness on the Lake and within the shadow of Mt Benson.

During my week with the Community, where I always feel lovingly supported and nurtured, I reread an old book, - thank you, Pat! - written in 1980 by Judy Tatelbaum called, The Courage to Grieve. While much of the content is now outdated, Judy's writing about effective support systems is still well worth sharing.

As we all know by now, an effective support system is crucial to Compassion Fatigue recovery and resilience. But what is an effective support system, exactly?

Judy Tatelbaum says that a good support system is composed of three parts:

1. Self Support:

Because few of us consciously count ourselves as part of our own support system, we can fail to attend to expanding our inner resources. It often takes a crisis like Compassion Fatigue to make us recognize our need for our own self-love, concern and support. The more we neglect ourselves, the more we deepen our depletion and impede our recovery.

Self support involves comforting and bolstering ourselves, listening to and accepting our feelings, paying attention to our physical needs, and making sure that all our needs are met rather than ignored. (This may sound impossible if you are early in CF recovery. If this is the case, you may need to draw on environmental and belief-based supports until you have "filled-up" enough to begin meeting more of your own needs.)

Recovery from CF and learning to stay well may require us to develop different self supports from those we're used to using - becoming more active or more quiet, learning to talk more or to be more contemplative, expressing feelings out loud or writing them in a journal, becoming more responsible to increase self esteem or taking a rest from responsibility for a while.

Honouring ourselves, (our needs and feelings), means showing concern for ourselves in all the simple things we do to make ourselves feel better. These needs are as variable and unique as we are.

2. Environmental Support:

Environmental supports are the network of people and activities that give our lives meaning. This network was once readily available through extended families living close together and in stable neighbourhoods or communities where people were known from birth until death. Now, in times of scattered families and greater transience, we must put effort into creating our environmental supports. If we don't, we can find ourselves unsupported and in great need when trouble arrives.

Many people have told me of the importance of their friendships during times of distress. We would certainly have been in difficulty had we not had friends to call upon during my husband's long illness. When I finally realized that I couldn't do it alone and needed respite, I sat down with my address book and phoned everyone we knew or had ever known - his friends, my friends, our friends, people from his work and my work, folks from organizations to which we'd belonged - and, after explaining our situation, I asked if they would sign up for a Wednesday or Saturday morning with my husband so that I could get some time away. The response was overwhelming. People cried on the phone because they had known of Derrick's illness and wanted to help but hadn't know how. The years we'd spent developing and nurturing relationships meant that we had the support we needed when self support wasn't enough.

Even if we have few friends, our environmental support system is larger than we might think. It comprises a wide range of people - intimates, family, friends, neighbours, colleagues, family physicians, health care professionals, psychotherapists or counsellors, clergy, lawyers, insurance agents, financial advisors, funeral directors, volunteers, local business people - and activities - adult education, work, volunteer work, clubs, travel, art, music, dance, support groups, sports, faith-based organizations, meditation, stress reduction activities, environmental work. Even if we haven't worked to strengthen this part of our support system, there is probably more there then we might imagine.

Philosophical or Belief System Support:

Tatelbaum says that whether our beliefs actually sustain us in a crisis is an individual matter but that our philosophy of life very much affects how well we cope with pain or problems. The meanings we ascribe to life, suffering and death can be key to how we survive the pain. For example, people who can accept sorrow and crisis as part of their own growth and development can find their beliefs deeply supportive.

So, much can be gained by consciously assessing the state of our support systems. What part of my support system is strong right now? What part could use a tune up? What is one thing I could do this week to increase my self, environmental or philosophical/ belief support system?