Category: Grief

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Understanding family members’ grief for a living loved one

Study looks at factors that influence pre-loss grief

By Emily Caldwell

The symptoms of grief people feel for a loved one facing a life-limiting illness fluctuate over time, a new study found – suggesting that individuals can adjust to their emotional pain, but also revealing factors that can make pre-loss grief more severe.

Researchers examined changes in the severity of pre-loss grief symptoms in people whose family members had either advanced cancer or dementia.

The study is the first to document pre-loss grief at two points in time, and found that about 70% of participants’ symptoms decreased over a month. However, compared to initial symptoms reported by participants, women and those with a heavy caregiving burden were more likely to be experiencing more intense symptoms a month later.

The results also showed that family members of patients with dementia, for which there is no long-term treatment or cure, were significantly more likely than family members of cancer patients to have severe pre-loss grief – but that some people anticipating losing a loved one to cancer also had unexpectedly high levels of pre-loss grief.

Participants reported similar symptoms no matter how long they had been living with the knowledge that their loved one had a life-limiting illness – another surprising finding for Jonathan Singer, lead author of the study and a clinical psychology intern in psychiatry and behavioral health at The Ohio State University.

“People in this study had pre-loss grief at a very high rate after many years. That was shocking, because one might think over time it would get easier. But with Alzheimer’s disease, it can get harder, and with cancer there could be a similar trajectory, starting with hope at the beginning but feeling worse over time,” Singer said.

“What’s happening with these family members still struggling – is it the caregiver burden, is it that they’ve lost their identity, is it that they’re not engaging in pleasurable activities anymore? That’s what we want to hit on next.”

The study was published recently in the Journal of Health Psychology.

Though pre-loss grief is not a clinical diagnosis, prolonged grief disorder in people mourning the death of a loved one has been added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) released this year. Clinical criteria for a diagnosis include preoccupation with thoughts or memories of the lost family member combined with a number of symptoms such as intense emotional pain, a sense of disbelief and difficulty moving on with life.

Adding prolonged grief disorder to the DSM-5 represents progress, Singer said – but the relatively new area of research on pre-loss grief demonstrates a need to consider therapies that can ease symptoms of people who are grieving for an ill loved one who is still alive.

“There’s a lot of research on anticipatory grief, which involves worry about the future. But pre-loss grief in that moment is pretty ignored,” said Singer, who treats patients at Ohio State Wexner Medical Center.

“With medical advances, people are going to be living longer with life-limiting illnesses, so there will be a bigger and bigger issue with grief before the person passes away. Symptoms of pre-loss grief can predict long-term negative outcomes after a loved one’s death, so this is a good intervention target that we should figure out now.”

Though it’s too soon to tell what types of therapies might work best, Singer noted two approaches that hold promise: behavioral activation that encourages people to engage in pleasurable activities, and meaning-centered psychotherapy designed to enhance spiritual well-being and quality of life.

For this study, the researchers recruited family members of patients with advanced cancer (100) and dementia (38) who completed questionnaires assessing their symptoms of grief, depression, post-traumatic stress and caregiving burden. Of those, 33 family members of cancer patients and 28 family members of dementia patients completed a follow-up assessment one month later.

The initial assessment showed that participants were experiencing substantial pre-loss grief. Women and participants with a higher caregiver burden were the most likely to be experiencing more intense grief one month later.

Overall, 69% of participants reported decreases in symptoms a month after the first assessment – a phenomenon that Singer plans to explore in follow-up studies.

There were no differences in pre-loss grief at baseline or one month later based on the nature of the life-limiting illness. But in a secondary analysis of the severity of reported symptoms, the researchers found that 10.5% of family members of dementia patients and 2% of family members of cancer patients met the criteria for a diagnosis of prolonged-grief disorder.

“We expected to see this severity in family members of patients with dementia,” Singer said. “But there is a lot of hope in the cancer community, so it was a big surprise to see so much pre-loss grief in family members of cancer patients.”

Singer led a recent study designed to help pave the way to a better understanding of how preparing for the death of a family member may prevent mental health problems for their survivors. He is currently involved in a study of a longer-term trajectory of pre-loss grief and is interested in investigating its biological effects.

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In Ghana, Funerals Are A Party.

But My Dad’s Couldn’t Hold My Grief.

Leonie Owiredu lost her father when she was young. His funeral was a loud celebration, full of family and friends, in keeping with Ghanaian custom. But in all that noise, she didn’t have the space she needed to grieve him.

By Leonie Owiredu

When I was four years old, I turned up to school in uniform on a day I wasn’t supposed to. I went to the school’s front desk and asked to call my dad to have him bring me my favorite outfit, a can of 7UP, and some sausage rolls. It was a brazen request that came from an assurance that my dad would always be there for me. When I was a bit older, and he fell ill, I believed that he would survive. My dad wasn’t supposed to die. He was supposed to walk up to the front of the congregation at our church to give his testimony of his survival. Everyone would stand up and join in praising God for such a miracle. When my dad died, it didn’t feel real. At 14, I had no direct encounter with death, nor did I know the weight it held in my culture. As the 10-year anniversary arrives this year, I’m still trying to figure it out.

From custom caskets to pallbearers, Ghana is a nation that takes pride in honoring the dead.

I’d just come home from boarding school for half term, when word spread that my father had passed. I watched as people flooded my door, eager to relieve their grief. My living room became crowded with distant relatives spilling over into the kitchen, claiming offense when I said I didn’t recognize them. This being my first funeral, and as a 14-year-old, I learned as I went on that funerals are the events that bring Ghanaians together. From custom caskets to pallbearers, we’re a nation that takes pride in honoring the dead.

Our mourning involves wailing, dancing to highlife and drum beats that help shake off grief, eating pots of waakye and jollof,drinking and wearing red and black clothing from Friday to Saturday, and then white on Sunday, to celebrate the person who once was. I witnessed the bustle the adults created for the first time over the designated days of mourning. My siblings, cousins, and I were pushed out of the living room and instead spent this time trying to mirror a celebration of our own upstairs by watching Beyoncé’s Live at Roseland; hearing her sing “I Miss You” while wiping away her tears gave voice to the feelings I couldn’t quite place. That performance especially carried me through my grief.

A lot of my participation in the funeral was decided for me, removing my agency to navigate through grief in a way I could understand. Perhaps the way adults grieve required a certain physicality that I wasn’t able to possess as a child. But my father always involved my siblings and me, affirming our voices through holding family meetings and considering our suggestions. So to be excluded from his funeral was unfamiliar.

The way adults grieve required a certain physicality that I wasn’t able to possess as a child.

There was an unspoken understanding that I was to serve the adults around me and be silent as they mourned, as if their grief trumped my own. These rules arrived via orders of “Don’t cry, wear this, and be strong for your mother.” These customs were foreign to me—still are foreign. I recently spoke to my 50-year-old aunt who lost her father at 12. I asked her why the perspectives of children aren’t considered. She said, “There was so much going on, the plan was just to get you through the events. They tell you where to go, what to say, and then after, they may explain.” I also asked my eldest cousin why after-care for children of the bereaved isn’t considered. Her response was, “Obi nhwɛ obi ba”: Nobody should look after anybody’s child. It was incredibly isolating to be surrounded by so many people, searching for permission to express my grief but constantly being denied. When an adult’s grief is valued higher than the child’s, all the grief is repressed and becomes cyclical—the child’s right to grieve continually placed to the side. After the immediate shock of death passes, the funeral rites are complete, and the doorbell stops ringing, everyone has decided that mourning is over. These rituals demarcated it as so. But for me, it had barely begun.

It was isolating to be surrounded by so many people, searching for permission to express my grief.

Children are deeply emotional creatures and are capable of far more depth and clarity than those around me would give them credit for. The adults wanted to fill their grief with celebrations. Their denial of my emotions at that time made me feel that they were something to hide; I could experience it only in short, and it had to be in private so as to not be an inconvenience to others. A happier child is easier than one who is sad. In attempts to deal with that internally, in my first year of grief, I denied myself of food. I stopped attending meals and began exercising more under the guise of pursing modeling, when my actions were in actuality an attempt to control feelings within my body. It was when other students at my boarding school noticed and kept inviting me to meals that one day I accepted, prompting a different dynamic with food as I grappled with the waves of grief.

A happier child is easier than one who is sad.

I lost the ability to experience the still silence that grief requires; I had to fill it with doing. What good was my hurt if I couldn’t help everyone process theirs? My grief was best in service, and I became really good at performing. I turned into a guru of sorts as friends and family piled in for support and advice. I knew exactly what to say and how to say it, because I longed for those things to be said to me.

As the years passed, I made three attempts at seeking counsel. It was my fourth and most recent therapist who helped me realize that I could navigate grief if I looked at what the experience was like for me. Now as a 20-something, I feel safe enough to move through grief and recognize those emotions with no shame. The weight of grief can be numbing at times, and then light; by giving myself permission to feel, it enables me to choose who to grieve with and how.

I lost the ability to experience the still silence that grief requires

In her poem “Taking Care,” Callista Buchen writes, “I sit with my grief. I mother it. I hold its small, hot hand. I don’t say, shhh. I don’t say, it is okay. I wait until it is done having feelings. Then we stand and we go wash the dishes.” I now know my feelings toward grief are neither good nor bad; they simply need to pass. A decade after my father’s death, I finally feel ready to honor those feelings.

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In grieving for her father, a novelist discovers the failure of words

Review of ‘Notes on Grief’ by Chimamanda Ngozi Adichie

Chimamanda Ngozi Adichie

By Carlos Lozada

Not all deaths in the time of covid are covid deaths. Even as we tally the fatalities resulting from the coronavirus — indicators of personal grief as well as national competence — we continue about the business of succumbing to non-pandemic maladies, deaths no less painful for their familiarity, grief no less wrenching for its disconnect from this plague upon us.

Novelist Chimamanda Ngozi Adichie experienced such a death last year, when her father, James Nwoye Adichie, a distinguished Nigerian academic, passed away because of complications from long-term kidney disease. In “Notes on Grief,” a slim, poignant reflection originating from a New Yorker essay of the same title, the author recounts her efforts to cope with her loss, to accept condolences, to carry out the inevitable rituals of death. “I want there to be a point,” she writes, but even looking for the point is so painful that she cannot fathom “the catastrophe of a direct, unswerving stare.” Grief is always hard to observe.

She writes of her father and his life and the void he leaves, only to find words wanting. With death, she explains, “you learn how much grief is about language, the failure of language and the grasping for language.” All the expressions of sympathy that come from her friends, well-intentioned interruptions of her pain, are inadequate, counterproductive, or they simply annoy. He is resting grates on Adichie in particular. “He could very well be resting in his room in our house in Abba,” the author complains. He is in a better place is not just cliched but presumptuous. “How would you know?” she demands. And when people emphasize that her father lived a long life (he died at 88), she takes little consolation. “Age is irrelevant in grief; at issue is not how old he was but how loved

Her own words have been little better, Adichie chastises herself, recalling her past condolences to grieving friends. Find peace in your memories, she would tell them, only now realizing that memories, rather than relief, produce “eloquent stabs of pain.” And when a friend reminds Adichie of the sentiment she expressed in one of her own novels — “Grief was the celebration of love, those who could feel real grief were lucky to have loved” — the author finds that the words, meant to console, felt “exquisitely painful.” The line is from “Half of a Yellow Sun,” published 15 years ago, back when it seemed she had all the time in the world.

Any one of us who has lost loved ones — even that euphemism feels deficient, for we have not lost anyone; we know too well what happened to them — can relate to Adichie’s anger and her compulsion to reshape it into guilt. She ponders ways she could have anticipated her father’s illness, steps she could have taken to fend off his deterioration, “to make it un-happen.” A brief respite in which she forgets his departure feels like a betrayal, Adichie admits, not only to him but to her relatives in Nigeria who were with him when he died, while she lives across the ocean in the United States. “Do I forget because I am not there?” she wonders. “I think so.” So Adichie seeks other ways to reaffirm their closeness: scouring her belongings for a family tree he once sketched for her, digging up his old letters. “There is an intense pathos to looking at his handwriting,” she realizes. It is as though in seeing his written words, she can again communicate with her father.

The pandemic’s unavoidable form of communication — the Zoom call — is ever present in “Notes on Grief,” as are other covid impositions. The book begins on a weekly family Zoom, with siblings dialing in and cracking jokes from England, the United States and Lagos, and the parents connecting from their home in Abba in southeastern Nigeria. (“Move your phone a bit, Daddy,” they have to tell him when only his forehead appears on the screen.) Her father had been feeling a little sick and sleeping poorly, she recalls, but he urged them not to worry. Three days later, he was gone. Their next Zoom call “is beyond surreal,” Adichie writes, “all of us weeping and weeping and weeping, in different parts of the world, looking in disbelief at the father we adore now lying still on a hospital bed.” And there are yet more Zooms in which they must discuss arrangements for the funeral and religious services. The logistics of death in a pandemic can feel overwhelming. Will Nigeria’s airports be open and stay open? How to ensure a covid-compliant Mass? “I come to dread the Zoom calls,” Adichie writes. “The family shape is changed forever, and nothing makes it more poignant than to slide on my phone screen and no longer see the square with the word ‘Dad.’ ”

That missing Dad emerges as a wise, kind, thoughtful and understanding presence throughout “Notes on Grief” — a devoted teacher, proud father and supportive husband, a man who instilled in the author the confidence to admit she did not know something, who taught her never to fear the disapproval of strangers. “He infused meaning into the simplest of descriptions: a good man, a good father.” I have no reason to imagine he was anything less than this father of which one might dream, yet even she realizes that grief can reshape perceptions. “No, I am not imagining it,” she writes in almost defiant affirmation. “Yes, my father truly was lovely

The loveliest writing in this reflection, however, is not about James Nwoye Adichie, but about the anguish and longing his death produces in those who suffer his absence most acutely. “Is this what shock means, that the air turns to glue?” Adichie asks, capturing her physical response to the news. “How is it that the world keeps going, breathing in and out unchanged, while in my soul there is a permanent scattering?” With death, we expect the world to mourn with us, and when it doesn’t, it can feel like an insult.

In the traditions of Nigeria’s Igbo people, Adichie explains, death involves a settling of accounts. This “clearance” requires that any outstanding dues to the village, the clan or other local associations be paid in full, otherwise the funeral will be boycotted. The custom shows how “forcefully communitarian” the culture remains, she writes. The author does not want to care about such things, but she must, because such things mattered to her father.

And it is in community that solace is possible. Sometimes, upon the death of a loved one, friends we had never met tell us stories we had never known. In death, those we love become more than we understood, more than we can ever remember alone. Adichie appreciates this power. She had always meant to interview her father at length, to record him as he retold and recounted the tales of his childhood, his parents and his grandparents. “I kept planning to, thinking we had time,” she laments. But others can help fill in those spots. “Concrete and sincere memories from those who knew him comfort the most,” Adichie writes. This is another way to settle accounts, one in which the community repays you many times over.

“Part of grief’s tyranny is that it robs you of remembering the things that matter,” the author writes, and I wonder if, in a deadly pandemic, such theft is even more prevalent. Yes, not all deaths in the time of covid are covid deaths, but not all covid deaths should be remembered solely for the crisis that brought them on, one more statistic in a global tragedy that we all just want to get past. They deserve more respect than that. Collective exhaustion should not rob them of individual grief.

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Mary Lincoln wasn’t ‘crazy.’

She was a bereaved mother, new exhibit says.

Mary Lincoln with two of her four sons, Willie and Tad, in 1860.

By Gillian Brockell

Callie Hawkins had been working at President Lincoln’s Cottage museum for 10 years when she became pregnant. She and her husband were thrilled, and she joked with her co-workers about the baby’s “perfect” due date — Feb. 12 — Abraham Lincoln’s birthday.

When the day arrived, Hawkins went into labor right on schedule. But when she and her husband got to the hospital, the medical team couldn’t find the baby’s heartbeat. Their son Coley James Hobbie was stillborn the next day.

Three years later, Hawkins sits on a picnic bench near the cottage where Lincoln and his wife spent more than a quarter of his presidency, pressing with her thumb a pendant around her neck that says “Mama.”

“After my son died, I got really afraid that people would maybe judge me or think about me in the way that history has remembered Mary Lincoln,” she said. Which is to say, she was afraid they would think she was “crazy.” In her lifetime, the former first lady lost her husband to an assassin’s bullet and three of her four children to disease. Her lengthy, public mourning defied conventions of the day and led to criticism and questions about her sanity.

With that in mind, Hawkins, now the interim executive director and director of programming at the cottage, helped to create a unique exhibit called “Reflections on Grief and Child Loss” at President Lincoln’s Cottage. In it, accounts of the Lincolns’ grief are presented alongside the stories of modern-day bereaved parents and their kids, showing their similarities across time

Abraham and Mary Lincoln (she did not go by Mary Todd Lincoln in her lifetime) had four sons; only one survived past age 18. Son Eddy died of an unknown illness at 3 in 1850; Willie died of typhoid at 11 in 1862, while the couple occupied the White House; and Tad died of a lung disease at 18 in 1871.

Back then, Hawkins said, “society allowed certain types of grief. You could wear black, you could have a mourning band on your stationery, and things like that.” But Mary Lincoln didn’t stick to what was socially acceptable. When Eddy died, she tore out her hair; when Willie died she was so overcome she couldn’t leave her bed for weeks and missed his funeral. She would cry loudly and wore black mourning clothes much longer than was socially acceptable.

The modern bereaved parents in the exhibit, who are anonymous, describe a society that is in some ways even more uncomfortable with expressions of grief than it was 150 years ago.

“I think society expected me to just move on,” says the mother of Jacob, who was murdered when he was 6. “I think it is still a surprise for some people that we still talk about her so freely,” said the mother of Abby, an only child who died at age 17 five years ago. “I think they are confused as to why we are still talking about her, assuming reflecting on her life, and death, only accentuates the pain.”

Hawkins encountered this discomfort when she presented the project to some colleagues. “Isn’t it going to make visitors sad?” they worried.

Yes, it will, Hawkins replied. And that’s a meaningful experience.

Some in Mary Lincoln’s day thought to grieve as deeply as she did was sacrilege. It showed she didn’t trust God’s will, they said. A modern-day mother described the same judgment from her religious community. “I thought my faith was not good enough because I was sad and angry,” she said. Like Mary, she lost three children — Julia, Matt and Charlie — in separate events.

Mary Lincoln also participated in seances with various spiritualists — generally con artists — who promised to communicate with her dead children, and later, her husband. Instead of judging her supposed gullibility, the modern-day bereaved parents’ testimonials give some context to her desire to feel the presence of the dead. They too seek ways to connect: in nature, in prayer, in activism or simply talking aloud to their children before they go to sleep at night.

President Lincoln felt these losses deeply, too, but he expressed it in more socially acceptable ways, like throwing himself into work, locking himself in his office or secretly visiting the crypt that temporarily held his son’s coffin at night. In a sexist society, his grief was viewed as a more heroic “melancholy” than Mary’s, who was dismissed as self-absorbed or insane — a stereotype that persists to this day.

The “Reflections of Grief at President Lincoln’s Cottage” places Abraham and Mary Lincoln’s grief over the deaths of their children alongside modern-day bereaved parents.

The exhibit has been designed in consultation with grief experts like professor Joanne Cacciatore, who has written several books dear to families going through traumatic death. So while much of it is intended to help bereaved parents feel less alone, it’s also meant to demystify this type of grief for people who may be unfamiliar or deeply uncomfortable with it. At the end of the exhibit, visitors can take with them a postcard-sized handout with tips on how to help someone who is grieving. Don’t try to fix it or distract them, it says. Show up.

“Other people are far more uncomfortable with my grief than I am. It’s a welcome part of my life now. I’m going to love Coley forever, so I am going to grieve him forever, and that is okay,” Hawkins said. “And we see that with Mary Lincoln. I mean, she grieved the losses of her children and her husband for the rest of her life. Even when it made other people uncomfortable.”

The exhibit puts a poignant emphasis on place and places of refuge. For the modern-day parents, that can be visiting their child’s grave, tending to a garden, sitting by a river or preserving their child’s bedroom. For the Lincolns, it was the cottage. While they had always planned to decamp to it during humid Washington summers, they didn’t get a chance to do so until shortly after Willie’s death. It was a balm to them, a peaceful place where they could just be. They spent the next two summers there as well.

In describing the cottage to a friend, Mary Lincoln wrote: “When we are in sorrow, quiet is very necessary to us.”

“I always thought that this was a truly special place, but I didn’t feel it in my bones the way that I do now,” Hawkins said. “I remember the exact moment, as I was sitting at the hospital, thinking, ‘Now I get it. Now I know. I know what they needed, and I need that, too.’ ”

Hawkins now sees the cottage as a place that holds broken hearts, both hers and the Lincolns’. Like the rest of the staff, she used to call their bedroom at the cottage the “Emancipation Room,” because it is where Lincoln wrote the historic Emancipation Proclamation. Now, Hawkins also thinks of it as a sacred place where the couple probably shed many tears together.

At the center of the exhibit springs a smooth white trunk evoking a weeping willow tree. On each dangling paper leaf, visitors are encouraged to write the name of a lost child, or someone else they love who has died. When the exhibit concludes in two years, each name will be transferred onto a sheet of seed paper and planted — all that love and grief sustaining something new and alive.

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How to Process the Death of an ‘Ex’

Consider funeral etiquette, emotional impact when a former significant other or spouse dies

by Susan Moeller

When a former spouse dies, divorce is no protection against grief. That’s what Linda Gravenson discovered when her ex-husband died in 2019. Although they had not lived together for 30 years, she found herself grieving his passing and the ultimate finality of their relationship. Yet as the former wife, she had no official standing in the process that followed his death, either emotionally or as a participant, except as their grown son’s mother.

“I wasn’t truly the widow,” says Gravenson, a freelance conceptual editor and author who, last winter, wrote an essay about her grief for The New York Times. “There was no place to go with that except internally back into my own memory.”

Gravenson’s experience hit a nerve. The essay, which described how her husband’s death sucked her down a hole of memories related to their relationship and the divorce, drew about 450 comments, either online or on Facebook. As she observed, there’s no cultural place for her category of grief. She didn’t feel comfortable, for example, joining a support group for widows.

“Did I qualify for support after 30 years of living apart?” she muses. “Can grief for loss be rekindled by final loss? I think that’s the real point of the piece.”

Acknowledge the grief

The death of a former spouse or long-term partner is a form of “disenfranchised grief,” meaning that society does not necessarily sanction it as legitimate, according to bereavement expert Kenneth J. Doka, who coined the phrase. In other words, since you are divorced, you should be immune from the grief of the loss. But experts say that the passing of an ex-spouse or partner can be intense. Gravenson, for one, had to finally let go of any hope that her husband would tell her that the 20-plus years they spent together “wasn’t nothing.” And, as Gravenson says, his death triggered grief over earlier losses.

“Bereavement really means it’s the permanent separation between you and the person that you loved or that you had an attachment [to],” says Michael Cruse, a licensed clinical social worker and the bereavement services manager at Hospice of Santa Barbara, a California nonprofit.  “But in that depth, it connects that bereaved person to all the other losses in their life. And usually there’s a loss in that marriage as well, because nobody plans to get divorced when they get married.”

These days, many of those splitting or getting divorced have been together a long time or share children. While the overall divorce rate is declining, the rate among those 50 and older has doubled since the 1950s, according to the Pew Research Center.

“In the modern world, ex-spouses don’t have to be enemies of one another,” Cruse notes. “They can actually be very civil and supportive in relationships. And so there’s still a lot of attachment.”

Assessing legal, funeral concerns

There’s no rulebook for attending a former spouse’s or partner’s funeral or for learning how to grieve the loss.

“Depending on how long ago it’s been since the person died, whether there’s kids or not kids, [there are] those practical questions of ‘Should I be involved in the funeral?’”  says Litsa Williams, a clinical social worker and cofounder of WhatsYourGrief.com, an online grief counseling service based in Baltimore.

If you find yourself in Gravenson’s situation — perhaps surprised by the grief you feel for a former spouse or partner and not sure about the emotions or the etiquette — here are some suggestions on how to move forward.

• Know where you stand legally. “If the ex-spouse is still the beneficiary on the insurance that can cause a lot of problems,” says Ellen McBrayer, president of Jones-Wynn Funeral Homes & Crematory, near Atlanta. Also, consider your own advance care directives, Williams advises. Clear instructions on end-of-life care or funeral arrangements will make it easier on adult children and other family members who may face decisions complicated by divorce or acrimony. “The more that someone can put their wishes in writing in advance, the easier it tends to be and the less conflict we tend to see,” Williams says.

• Communicate openly and respectfully. Williams and others suggest having a conversation with extended family or the most diplomatic family member so you can explain what’s important to you about being at a service and ask how others feel. It’s even better if you can talk before death occurs. Then, she says, be open to negotiation. For example, maybe your ex-spouse’s wife would be comfortable with you at the funeral but not coming back to the house afterward.

Try to reach a place where “everybody can feel like they’re having their need for that ritual met … while being respectful of each other,” Williams says.

•Talk with the funeral director. McBrayer stresses that funeral homes want to create safe spaces for families to grieve, even if that means holding two services or figuring out another way to commemorate the death. While they can’t mediate family conflict, funeral directors and pastors can help brainstorm a solution or provide a neutral location to talk.

“Family dynamics in general can be complicated with blended families,” McBrayer points out. “So we just really try to work with a family.”

• Get support. You may think that you are the only one who doesn’t fit into the traditional architecture of bereavement, such as widow support groups, but others have the same issue. “We hear this all the time,” Williams says. “I’m too young to go to a widows group. My husband died of an overdose; their husbands died of cancer. I’m in an LGBT relationship … everyone else there is straight.”

If you decide to join a bereavement support group, she suggests being upfront about your anxiety, to see if it’s the right place. Cruse recommends starting with individual therapy. He says the Santa Barbara hospice organization works with clients individually first and then suggests a support group if appropriate. You can also find help online, through bereavement counseling practices like What’ s Your Grief or through peer-supported grief forums, such as that run by Marty Tousley, a former bereavement counselor.

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Epictetus on Love and Loss

— The Stoic Strategy for Surviving Heartbreak

Epictetus

“Who is good if he knows not who he is? and who knows what he is, if he forgets that things which have been made are perishable, and that it is not possible for one human being to be with another always?”

By Maria Popova

“Future love does not exist,” Tolstoy wrote in contemplating the paradoxical demands of love. “Love is a present activity only. The man who does not manifest love in the present has not love.” It is a difficult concept to accept — we have been socialized to believe in and grasp after the happily-ever-after future of every meaningful relationship. But what happens when love, whatever its category and classification, dissolves under the interminable forces of time and change, be it by death or by some other, more deliberate demise? In the midst of what feels like an unsurvivable loss, how do we moor ourselves to the fact that even the most beautiful, most singularly gratifying things in life are merely on loan from the universe, granted us for the time being?

epictetus_discourses.jpg

Two millennia ago, the great Stoic philosopher Epictetus (c. 55–135 AD) argued that the antidote to this gutting grief is found not in hedging ourselves against prospective loss through artificial self-protections but, when loss does come, in orienting ourselves to it and to what preceded it differently — in training ourselves not only to accept but to embrace the temporality of all things, even those we most cherish and most wish would stretch into eternity, so that when love does vanish, we are left with the irrevocable gladness that it had entered our lives at all and animated them for the time that it did.

In The Discourses of Epictetus (public library), under the heading That we ought not to be moved by a desire of those things which are not in our power, the Stoic sage writes:

Who is good if he knows not who he is? and who knows what he is, if he forgets that things which have been made are perishable, and that it is not possible for one human being to be with another always?

Epictetus — a proponent of the wonderful practice of self-scrutiny applied with kindness — proceeds to offer a meditation on loosening the grip of grief in parting permanently from someone we have loved:

When you are delighted with anything, be delighted as with a thing which is not one of those which cannot be taken away, but as something of such a kind, as an earthen pot is, or a glass cup, that, when it has been broken, you may remember what it was and may not be troubled… What you love is nothing of your own: it has been given to you for the present, not that it should not be taken from you, nor has it been given to you for all time, but as a fig is given to you or a bunch of grapes at the appointed season of the year. But if you wish for these things in winter, you are a fool. So if you wish for your son or friend when it is not allowed to you, you must know that you are wishing for a fig in winter.

“How Long Is Now”

In a sentiment addressing the corporeal mortality of our loved ones, but equally applicable to the loss of love in a non-physical sense, Epictetus adds:

At the times when you are delighted with a thing, place before yourself the contrary appearances. What harm is it while you are kissing your child to say with a lisping voice, “To-morrow you will die”; and to a friend also, “To-morrow you will go away or I shall, and never shall we see one another again”?

When we are able to regard what we love in such a way, Epictetus argues, its inevitable loss would leave in us not paralyzing devastation but what Abraham Lincoln would later term “a sad sweet feeling in your heart.” To retain the memory of love’s sweetness without letting the pain of parting and loss embitter it is perhaps the greatest challenge for the bereaved heart, and its greatest achievement.

Complement this particular fragment of Epictetus’s abidingly insightful Discourses with computing pioneer Alan Turing on love and loss and other great artists, scientists, and writers on how to live with loss, then revisit more of the Stoics’ timeless succor for the traumas of living: Seneca on resilience in the face of loss, the antidote to anxiety, and what it means to be a generous human being, Marcus Aurelius on living through difficult times and how to motivate yourself to rise each morning and do your work.

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Can Losing a Loved One Make You More Grateful?


Research suggests that loss can remind us of the preciousness of life—a lesson that one researcher learned firsthand.

By Nathan Greene

My sister and I sat in my mother’s bedroom—her sanctuary and prison, where cancer had kept her confined on and off for the past six years—as she looked out the window longingly. The stunningly sunny July day reminded her of everything she loved doing outdoors: tending to her roses, smelling strangers’ babies’ heads, cheering for her children on the cross-country course.

She was getting cranky. Hindered by dry lips but motivated by restless legs, she pleaded in her best Jewish grandmother voice. “You guys have gotta get me out of here,” she said, smiling coyly. “I’m dyin’ in here…”

Morbid, mom.

My sister and I exchanged a skeptical glance as we looked at the tubes and machinery she was connected to, the bag of nutrients that was keeping her alive, and considered the implausibility of any excursion. Though mom clocked in at 5’2” and under 100 pounds, we knew a battle was fruitless; when she set her mind to an idea, we had no chance of stopping her.

A self-identified flower child who read Pema Chodron and Thich Nhat Hanh, my mother fought two forms of cancer over 16 years before her death. The disease took her hair, breasts, ovaries, fallopian tubes, and uterus, along with a third of her intestines. But her humanity grew. Following her first diagnosis when I was three, she and her closest friends championed a non-profit called Healing Odyssey, a women’s retreat for cancer survivors.

As odd as it may seem, I am a more grateful person today as a result of losing my mother. As I watched her fight with her everything to stay on this planet—to spend another day with my father, the love of her life, and to support my sister and me through our trials and triumphs—I began to value my life more.

Of course, I had moments when I raged at the top of my lungs at cancer, and I’ll never forget when the man from the morgue wheeled her body out of our house for the last time. But my appreciation for life also grew undeniably—and it led me to conduct research that would eventually explore how the death of a parent can inspire gratitude.

Grateful after loss

Nine years following my mother’s death, I was studying loss, childhood trauma, and resilience for my doctorate (they call research “me-search,” after all). I began wondering whether the experience of gratitude growing through loss might be universal. Early on, I came across a study that showed that our sense of gratitude can increase when we reflect in a personal way on our own death.

The authors of this study attributed the phenomenon to the “scarcity heuristic,” whereby we value things more when they are rare or scarce. So when we’re faced with death, the value we place on life rises. This was my experience. In witnessing my mom die at 53, suddenly life felt very short, and each moment became incredibly important.

I was excited to see my experience mirrored back to me in research, and inspired to study whether losing a parent in childhood made people more grateful. As a starting point, Katie McGovern and I asked 350 adults who had lost a parent about their gratitude, depression, psychological well-being, and post-traumatic growth (positive change experienced following a major personal crisis or traumatic experience), as well as how their gratitude changed as a result of the loss.

Unsurprisingly, we found that those who rated themselves higher in gratitude reported lower levels of depression, and greater levels of psychological well-being and post-traumatic growth. In other words, the more grateful participants were faring better than those who were less grateful.

Even more interesting, though, was that 79 percent of respondents believed that their experience of gratitude increased as a result of losing their parent, as opposed to roughly 13 percent who reported no change in gratitude and only 8 percent who reported that their sense of gratitude decreased.

Because this study was correlational, questions still remain regarding whether adults actually developed gratitude because of the loss or were already grateful people beforehand. Also, it may have been difficult for people to accurately remember their gratitude levels prior to the loss. As such, we could only speak to their perceptions of changes in gratitude. Stronger evidence would come from a long-term study that observes how gratitude changes in children before and after losing a parent, compared to children who don’t lose a parent.

“Losing my mother reminds me daily how precious life is and that I shouldn’t take a single second for granted”

Still, a large majority of the adults in the study felt as I did—that losing their parent made them a more grateful person. In order to understand this in a more nuanced way, we invited people to write about their experience and analyzed the responses. The most common themes that people reported were related to realizations that life is precious, feelings of gratitude for family and friends, and a recognition of impermanence.

I was particularly moved by a quote from one woman in the study. “Losing my mother reminds me daily how precious life is and that I shouldn’t take a single second for granted,” she said. “From darkness I eventually came into the light.”

When gratitude is hard

My mother was a wonderful, thoughtful person who tried as hard as she could to make hers a “good death.” She joked about mortality and signed notes to us with “I love you eternally,” part of a broad campaign to prepare my family for her death. She wrote letters to my sister and me to be opened on our wedding days, and she recorded herself on a Walkman reading our favorite childhood stories so she could read to her grandbabies. As painful as it was to see my mother suffer over multiple years, we were given the gift of time. We held each other and laughed and cried together as much as we possibly could have in that period between diagnosis and death.

When I entered into my research about loss and gratitude, I wanted to acknowledge that not everyone who had lost a parent had experienced a “good death” as we had. They may not have had a parent who was so conscientious about preparing them for their death, a close relationship with the parent, or the opportunity to say goodbye. I didn’t want the research to paint an unrealistically rosy picture or minimize the incredible pain that comes with loss. And the last thing I wanted was for those who were grieving to feel like they should be feeling grateful.

As a result, we also studied why it was challenging for some of the participants to access gratitude following the loss of a parent. We found, unsurprisingly, that those who experienced additional traumatic events in adulthood were struggling more. When people believed their gratitude decreased following the loss, they tended to attribute it to fear, anxiety, and a feeling that they couldn’t depend on others.

I most certainly do not feel grateful every day. I become angry every Mother’s Day, and embarrassed about the envy I feel toward the beautiful connection my best friend has with her one-year-old son. In every accomplishment or milestone I achieve, there is a tinge of melancholy—it serves as a reminder that the world has continued spinning without my mom in it.

In living with this incredible burden and gift of parental loss, no feelings are simple or singular. In the overwhelming wave of sadness I feel envelop my heart when I smell her perfume on a stranger or wake up from a dream in which she visits me, there is also a deep achy joy in feeling connected to her. This is the gift of grief: an opening to the complexity of moment-to-moment experience, which, for me, inevitably gives way to gratitude.

What truly matters

On that July day, we carefully guided mom into the passenger seat of her yellow Volkswagen Beatle and drove to an overlook in Laguna Beach. Left arm clasped to mine and right arm clasped to my sister’s, my mother shuffled down the pathway leading to the water. With a halt, she pointed out a crop of angel-wing jasmine. “You guys have to smell these,” she coaxed, with that same look she would have in front of a piece of chocolate cake—eyes wide, guilty of an indulgence. I watched her as she closed her eyes, dipping her face into the small, star-shaped flowers and drinking in their scent as if they were a life force.

We continued down the path toward the edge of a cliff—a meeting place between two worlds—and pressed against the railing. The three of us stood, hand in hand, and our eyes softly closed as the sun warmed our skin. For the first time in the six years since she was diagnosed with ovarian cancer, our shoulders released. We breathed fully and calm swept over us.

“This is where spirituality lies,” my mother said, with the surety of a new discovery. Staring death in the face and marveling at the supreme beauty of the universe, something in her had shifted. Her mama-bear stubbornness, her moments of confusion, anger, and sadness, were replaced by a calm acceptance. And my sister and I followed her lead.

Mom took us to the edge that day with her, to confront our own deaths as well as hers. In moments like this, what truly matters quickly shifts into focus; it becomes glaringly obvious that our time here is so finite and death can come at any moment. As the sea salt mist caressed our faces, we held each other tightly, in preparation for letting go.

Complete Article ↪HERE↩!