Waves in an Ocean of Grief
When considering what to write this month I found myself continuing to encounter examples of the constant presence of loss and grief in our lives both in the small everyday ways and larger, tragic events. Whether I heard it in session with clients, in support groups, talking with friends and family, or watching the news, people in general and especially grieving individuals are recently finding themselves overwhelmed by the impact that recurrent loss or reminders of loss can have on their wellbeing. As a mother and a grief professional, I too, have recently struggled to find the balance.
We often talk about the grief and healing experience as coming in waves. There are ups and downs and we are constantly moving, backwards and forwards, sometimes with more difficulty treading water than other times. Sometimes we feel like we are making progress, whatever that might look like for us. And sometimes we are just staying afloat. But what about times when it seems that we are overcome by not just waves, but rather an entire ocean of grief where there is no relief, no calm waters, only huge swells and an uncertain horizon?
In grief there are typical, everyday “grief bursts,” or sudden bursts of feelings that come out of nowhere or are tied to an otherwise seemingly innocuous occurrence like a song on the radio or a familiar smell that reminds us of our loved one. There are the common, expected triggering events like birthdays, anniversaries, holidays, or special events that underscore their absence in our lives. These grief bursts or triggers are normal and expected, but they can still lead people to worry about their grief process, expressing concern that they felt like they were doing better, but are now feeling worse again. Grieving individuals can feel discouraged that they are “right back where they were” despite how much time has passed. Yet as time continues and people are able to ride these waves and find relief in the times in between, they can often learn how to avoid them, plan for them, or practice how to cope with them.
But then there are times, as we seem to find ourselves in now, that the constant presence and reminders of grief and loss can overwhelm us with those all too familiar feelings of sadness, pain, trauma, and isolation.
The recent rise in COVID-19 cases has reignited those feelings of fear and worry about the health of those around us, especially the most vulnerable. COVID positive individuals needing to isolate themselves, even just for 5 days, is bringing people back to the crippling isolation and loneliness they experienced at the height of the COVID-19 lockdown 2 years ago. The progress towards normalcy we’ve made with lifting mask mandates and gathering in celebration again is reminding those who have to miss out because of COVID exposure or sickness how much we as a society have missed out on for the past couple years – the graduations, the weddings, the births, and the everyday milestones.
The shootings in Uvalde, Buffalo, and countless other communities, whether it affects us directly or is consumed by us through the news, surrounds us with anger and sorrow. Witnessing such pain can be extremely traumatic and scary for all of us, and even more so for grieving individuals. It can bring us back to that very raw, visceral place in our grief, reminding us of the trauma we’ve experienced and seeing ourselves in the anguish of those who are currently suffering. Grief has an enormous impact on both our emotional and physical health and hearing the news that the husband of one of the slain Uvalde teachers died 2 days later of an apparent heart attack only underscores the need for bereavement support.
I was asked earlier this week what words of support I would have for the families of Uvalde and I found myself at a loss. As grieving individuals know, sometimes there are no words.
But for those in our community, in times like these when the ocean of grief is wider and deeper than feels possible to manage, be gentle with yourselves.
Turn off the news when it becomes too much to bear. If you have young children you’re caring for, make it a pajama and TV day. If activism or service feels meaningful and productive, do that. Give yourself the opportunity to process feelings with those around you and give yourself the space to not talk about it if that’s what you need. Have compassion and grace with the feelings that arise and use every tool you have to care for yourself.
Know that just like with the song on the radio or that milestone anniversary, you will make it through this time and none of us has to do it alone.
Claire Sharkey, LCSW
Clinical Director, COPE Foundation
Mental Health Awareness Month: Facilitator Spotlight
We were halfway through April when I realized it was no longer March. As for much of the pandemic, time has simultaneously stood still and rushed forward in bursts. In realizing we were in April, I reflected that March was the 2 year anniversary of when the world stopped with the beginning of the pandemic. As we enter May, we begin Mental Health Awareness Month. These two things are inextricably linked; the pandemic has added new layers to preexisting life stressors or mental health conditions and created a whole host of struggles, concerns, and worries that never existed before.
Like many in the service industries, mental health professionals have stepped up over the past two years to support the growing mental health needs of a significantly exhausted, distressed, isolated, and burnt out population. While navigating their own pandemic-related fears and personal challenges, mental health providers have expanded practices, embraced the benefits of technology to increase access, and adjusted hours to accommodate other needs. As we approach 1 million lives lost from the COVID-19 pandemic, grief and bereavement providers especially have found their expertise and support needed.
It is because of this and all the other wonderful work they do, that I want to recognize and highlight our COPE facilitators this month and thank them for their commitment to and unwavering support of our community. We have facilitators who have been with us since COPE’s inception and those who have joined us as recently as this month, but all of them bring knowledge, compassion, personal and professional expertise and experience to their groups. They have seamlessly transitioned groups from in person to virtual platforms, welcomed and supported new group participants who they have only ever seen from the shoulders up, and continue to be open to flexibility and new requests because they care so deeply for their groups and their participants.
Group support is so unique because of the validation, normalization, community, and camaraderie one receives from being with peers who have had similar experiences. Adding a skilled clinician to the peer group enhances the conversation, education, and healing that is possible. COPE would not have been able to continue to provide support over these past two years without them. They are a huge part of what makes COPE’s community special.
Thank you Marilyn, Janet, Mary Ann, Michelle, Lauren, Juan Carlos, Natalia, and Erika. We appreciate you!
And to you, our COPE community, especially during Mental Health Awareness Month, reach out for support and take care of yourselves. You are not alone.
Prolonged Grief Disorder
The newest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V TR) includes a new diagnosis known as Prolonged Grief Disorder. Along with many in the grief community, this new addition has been an important topic of conversation for months among our staff and leadership, which includes both bereaved individuals and clinicians (and many who are both) and even among our COPE families.
For many the topic is sensitive or controversial given the fear of pathologizing grieving individuals, telling people there is something wrong with them or the way they are grieving, or setting strict stages or timeframes for grief. For others it is validating to find new language and even labels to show those who may not understand their grief experience that grief is a very real challenge with enormous impact on one’s life and that in many cases interventions or the best forms of coping are unclear.
It is important to those of us at COPE to continue to normalize the grief experience, educate our community on the many facets of grief and bereavement, and provide and increase access to services to those who are grieving whether through our own programs or referrals to other organizations. We hope to support individuals and validate their experiences through connecting them with other bereaved parents, siblings, and children. We also hope to reduce stigma around mental health diagnoses, mental health services, and the fear of seeking out help when it is needed. The importance of finding support is even more imperative given research that shows there are some elevated physical health risks for those who are grieving. The compounded risk grief has for an individual’s physical and mental well being cannot be ignored. Our goal is for our community to know they are not alone and there is support available.
As many in our community can attest, there is no “getting over” grief. Our grief will always be with us, but we learn to grow around our grief and to cope with the feelings that in the beginning (or even for a long time after) might have seemed impossible. We can cope with our grief by leaning on our social supports, engaging with our grief through various forms of therapy and self-care, and through maintaining a continuing bond with our loved one through memories or the ways we have chosen to honor them.
For others though, grief may become so overwhelming for so long that it significantly impairs daily functioning and finding ways to cope with it becomes impossible. In these cases, extra support and help is needed. This might happen for many reasons – circumstances around the death, lack of other supports, other life stressors, or pre-existing personal conditions or risk factors.
The need for additional help should not be stigmatized or conflated with other mental health conditions. Though it may have similarities to depressive episodes or traumatic responses, grief and its treatment should be considered uniquely different. The inclusion of Prolonged Grief Disorder in the DSM-V TR is an important step in distinguishing grief from other mental health disorders and validating the complexity of the grief experience. It also opens doors by allowing more clinicians to provide insurance-covered mental health treatment for those individuals who cannot afford to pay for these services on their own, increasing access to these resources.
Some of COPE’s clinical leaders have received training at Columbia University’s Center for Prolonged Grief (previously Center for Complicated Grief) or with its founding director, Dr. Katherine Shear, and have found the approach to treating Prolonged Grief to be a compassionate and behavioral approach, appreciating that the goal is not to cure someone of their grief, but rather to help them find it more manageable.
Their website provides definitions of prolonged grief and its diagnostic criteria and also defines other forms of grief. We encourage you to explore these resources if you want to learn more about Prolonged Grief or think this form of grief treatment might be helpful for you.
We also invite you to reach out to us for additional resources, referrals, or support.
Lastly, we want to share some recent media on Prolonged Grief Disorder to further the conversation.
How Long Should It Take to Grieve? Psychiatry Has Come Up With an Answer.
The Loss of a Child Takes a Physical Toll on the Heart
Grief, like death, is still taboo for many of us. But is that starting to change?
As COVID Deaths Rise, Lingering Grief Gets a New Name
The Legacies Our Loved Ones Leave Behind
Over the past two months, I attended the funerals and shivas for the mothers of two friends. I did not know either mother very well other than having met them through my friends’ weddings or having heard about them through their children and I knew that both had struggled with illness for many years.
I was there primarily to support my friends, but even over Zoom, I found myself enraptured and moved while listening to their various loved ones speak about them during their funerals. I felt honored to hear about their vibrant and rich lives and their tenacity in the face of their illnesses. The stories were genuine and raw, filled with fond memories and deep heartache, encapsulating each of their spirits.
As a child who went to many funerals of much older relatives, I was always surprised and intrigued to learn about their long lives full of interests and hobbies and quirky personality traits, as my limited childish capacity was only to have known them as “old.”
It was something that resonated with me again when I worked for 8 years in a hospital and we educated the staff on recognizing that our patients were more than just sick people in a hospital bed. Outside of the hospital they were mothers, sons, CEOs, and world travelers, who were defined by more than their illness. Patients often put photos of themselves doing the things they loved in their rooms so that staff saw this upon entering and remembered that this was a unique individual, not just another patient. It called on us as providers to recognize the humanity in medicine, illness, and death even through our compassion fatigue or burnout.
What struck me in ruminating on all of this after these funerals was how this impacts part of our grief process. Our journey might mostly feel like post-traumatic stress, but there can also be post-traumatic growth. Alongside our pain and mourning, part of our work in navigating our grief is finding that touchpoint that will allow us to remain connected to our loved one and recognize the impact of their life, no matter how short. The goal is not to get over our sadness or move on from missing our loved one, but to build those continuing bonds with them and find a new way to maintain or even grow that relationship in its different form.
We are able to do that because in many ways they are still with us. They remain in the memories we have or stories we share. In their children and grandchildren. In the beautiful watercolor art they made or the perfectly curated record collection they kept. They live on in how we adapt to this loss and make meaning in supporting those around us, honoring them through pursuing higher education or trying to perfectly mimic their best recipes, planting trees or putting a plaque on a bench in Central Park, or starting foundations to fund research for cancer or support bereaved individuals. This connection, growth, and meaning making can be an important piece of our healing process and allow their life to continue albeit in a different form.
Claire Sharkey, LCSW
Clinical Director, COPE Foundation
Grief and Valentine’s Day
I read somewhere recently that in French “I miss you” is “Tu me manques,” which literally translates to “You are missing from me.” Assuming this translation is correct (and I have not let down my six years worth of French teachers), I think there is no truer way to express the love that remains after a significant person dies. Our love for them and the space left by the missing piece of us after their death takes the form of grief. This resonated with me especially as we near Valentine’s Day, a day dedicated to the love we have for those around us and those this year that we might find are missing from us.
Though many people choose to brush aside this day, for those that are grieving it might feel harder to ignore, and might feel especially triggering after having recently made it through the often challenging holiday season and into a new year with the difficult milestone of being another year they have not lived with us.
If Valentine’s seems like it might be a difficult day for you and not one that you will be able to move through by distracting yourself or ignoring it entirely (which are acceptable ways to cope with the day should you choose) here are some suggestions to focus your energy and reframe the day if they are accessible to you:
Reach out to the important people in your life. Connect with your other loved ones with phone calls or texts or meet up for a coffee or meal. Send a card or bouquet of flowers to someone who has been particularly there for you. Fill the day reminding yourself of the support people in your life and by reminding them of the love they have from you.
Reach out to those you struggle to love. Perhaps there is a coworker that you find particularly difficult to interact with or a family member you have recently been struggling with because they have not been supportive of your grief process. Maybe this day is an opportunity to take the first step in mending that hurt or shortening that distance. Maybe it is simply avoiding negative thoughts about them or practicing patience when they frustrate you. Offering them grace and compassion will have benefits to your own wellbeing.
Reach out to strangers. Fill the day with small random acts of kindness like covering the cost of someone’s coffee or leaving a generous tip. Take the extra moment to smile or say good morning to the doorman or wish the checkout clerk at the grocery store a nice day. Look for opportunities to volunteer or donate to a cause close to you or your loved one’s heart. Fill your community with a little extra love.
Reach out to yourself. Do not underestimate the importance of self-love and self-care. Lean into your grief and give yourself permission today to focus on you. Eat a meal you enjoy. Carve out time for your favorite exercise class. Buy yourself a small gift or get a manicure. Sleep in late or go to bed early. Whatever it means to care for and treat yourself, do that. Fill your cup.
Reach out to your loved one. Even if your loved one is not physically with you, you can still take the opportunity to connect with them that day. Visit the cemetery, share happy memories with family and friends, enjoy pictures and videos of the times you had together, write a letter to them expressing the love you still have for them and the moments you miss. Honor them through the ways you reach out to those listed in suggestions 1-4 above. Remind yourself that your grief is their love persevering.
As we enter a new year, exiting one that for many was filled with challenges, disappointments, and many losses, we also look back on the moments we were able to come together with our COPE community for connection, support, tools, and resources. So many people are living with grief and no one needs to face this journey alone.
The beauty of this community – this family – was clear at our December Worldwide Candlelighting Memorial Service. In concert with many other organizations, we remembered the children gone too soon by lighting our candles and sending a wave of light across the world beginning at 7PM local time.
We honored them by sharing their names and stories and inspired and moved one another with poems, lyrics, quotes, and prayers. A number of times after listening to someone share a reading, another participant expressed thanks for the comfort the words had provided. I am including here some short poems from that night and in doing so, I hope to share some of that comfort with each of you. May it support you as we move forward into 2022.
“On the Death of the Beloved”
Though we need to weep your loss,
You dwell in that safe place in our hearts,
Where no storm or night or pain can reach you
Let us not look for you only in memory,
Where we would grow lonely without you.
You would want us to find you in presence,
Beside us when beauty brightens,
When kindness glows
And music echoes eternal tones.
I blow your kisses to the sky
And off to you I let them fly
Each one a wish I wrap in love
Then send to you so high above
I feel you watching as I do
And know you hear each “I love you”
So everyday I’ll send them high
These kisses I blow to the sky
“Until We Meet Again”
Those special memories of you
will always bring a smile,
if only i could have you back
just for a while.
Then we could sit and talk again,
just like we used to do.
You always meant so very much,
and always will do too.
The fact that you’re no longer here,
will always cause me pain,
but you’re forever in my heart
until we meet again.
Claire Sharkey, LCSW
Clinical Director, COPE Foundation