Our Collective Loss of What’s Normal

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While it was certainly an adjustment, overall, I felt like I came out of COVID-19 unscathed. I’m certainly not trying to brag. I was, and still am, fortunate to work from home when I need or want to — and most of our employees are able to do the same. I was really grateful for the quality time with my family, finally getting around to projects that I’d been putting off, and it even enhanced my business savvy.

Our Collective Loss of What’s Normal

With so many other people suffering and trying to get back to work — and the economy is struggling — I don’t take it for granted that I’m grateful every morning when I wake-up. I do, however, long for the good-ole-days.

I’m certainly not the only one. Anecdotally, when I catch up with friends, family, and colleagues — some still want to meet virtually — I can hardly tolerant virtual meetings anymore. And now, the numbers have started going up in many areas of the country because of non-vaxxers.

In short, we all started to miss what we considered “normal.” According to David Kessler, author and grieving expert, that’s because we started feeling different types of grief.

Why we’re grieving — All of these things happened in Covid — and some still feel it.

“We feel the world has changed, and it has,” Kessler told HBR. “We know this is temporary, but it doesn’t feel that way, and we realize things will be different.”

“The loss of normalcy; the fear of economic toll; the loss of connection,” he adds. All of these are “hitting us, and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.”

Additionally, we’re also dealing with anticipatory grief — like when the numbers started going up about a week ago — what if we have to do this all over again? We will go through anticipatory grief when we’re uncertain about the future. “Usually, it centers on death,” he says. “We feel it when someone gets a dire diagnosis or when we have the normal thought that we’ll lose a parent someday.”

“Anticipatory grief is also more broadly imagined futures,” he says. “There is a storm coming. There’s something bad out there. With a virus, this kind of grief is so confusing for people.”

The reason for this is because our primitive minds realize that “something bad is happening. However since you can’t see it, “our sense of safety” is broken, he adds. “We’re feeling that loss of safety.”

“I don’t think we’ve collectively lost our sense of general safety like this,” Kessler says. “Individually or as smaller groups, people have felt this. But all together, this is new. We are grieving on a micro and a macro level.”

If there’s any silver lining, though, it’s that there are simple and effective ways to cope. For starters, Kessler recommends understanding the stages of grief and learning calming techniques. But, you should also try these nine other strategies to help you accept and manage your feelings.

1. Don’t get stuck.

“I see a lot of jokes on social media about drinking at 10 a.m. and sharing ‘quarantinis’ over video chats, almost to the point of normalizing these self-medicating behaviors,” writes Megan Seidman, a primary therapist at Caron Renaissance. “People are cut off from their usual methods of coping, and many are turning to unhealthy ways of immediate gratification to numb their discomfort.”

It should go without saying that not only is that dangerous in the short term, but it could have long-term implications. Besides putting your health and wellness in jeopardy, being funny about the consequences of much sadness may give people ideas who are on a different level of pain — and could lead to substance abuse.

Some people never allowed themselves to grieve, and now they think we might be back in the same problems that happened a year ago. They “haven’t allowed themselves to feel the loss, fear, and grief they have,” they may experience “complicated grief and post-event trauma.”

“Complicated grief becomes all-encompassing, making it difficult for people to think about anything else,” explains Seidman. “They cannot accept the reality of the losses they’ve experienced and therefore fail to adjust to the new reality.”

What’s more, it’s going to be more challenging for these individuals to get “back into their former routines.” Seidman warns that we could “see issues in ongoing relationships, divorces, rumination over losses, and difficulty sleeping. Once the social distancing is alleviated, if people haven’t worked through this process, they’re going to have a harder time reconnecting with others.”

2. Add predictability.

You may have never thought about this until your routine was broken due to the pandemic. But they’re incredibly important. First, Northwestern Medicine notes, “offer a way to promote health and wellness through structure and organization.”

Now we’ve headed back to the office — but maybe you haven’t committed to going into the office every day as before. Maybe you don’t have a routine yet — this can make you suffer from stress, unhealthy eating, and insomnia.

If you gained a few (or a lot) of the Covid-pounds — you may have gotten yourself in poor physical condition. And, you may be ineffectively using your time and feeling non-productive.

To counter the above, add some predictability to your life. Personally, I’ve started a new routine. It took some trial and error. But I set a routine of when I will be in the office and when I will work from home. I also had all of the employees commit to a determined schedule. It helps all of us to know what is going on and when.

If you’re struggling with this, here are some pointers to get you on your way:

  • Build your resistance. Don’t waste your energy fighting against change. Instead, accept it, practice some self-care, and focus on your current priorities.
  • Follow your usual patterns. If you wake up at 5 am, start work at 9 am, and eat dinner at 6 pm, try to keep that schedule. You may need to be flexible, but sticking to your previous schedule as close as possible gives you a sense of normalcy.
  • Schedule your habits in your calendar — schedule healthy habits like exercise or writing so that you’ll follow through. Physical activity is a proven way to reduce anxiety and depression.
  • Create an optimal environment. If you’re working from home, create a dedicated space reserved only for work. Don’t forget to keep it cleaned and organized as well.
  • Ask for help if you’re struggling — reach out to your support systems like a mentor or friend.
  • Take a reset day. Sometimes you need to take the day off and get things in order. But don’t squander this opportunity. Instead, use it to clean your house, review your goals, or tie up any loose ends.
  • Be the tortoise. A new routine won’t happen overnight. So be patient and work your way back into a routine.

3. Connect with others.

Last year — all the stay-at-home orders, quarantine, and social distancing took a toll on your mental health. Why? According to Julianne Holt-Lunstad, a professor of psychology and neuroscience and director of the Social Connections and Health Research Laboratory at Brigham Young University, it’s because “being socially connected in meaningful ways is actually key to human health and survival.”

While this was a concern before the pandemic, it does highlight the importance of connecting with others. So if you are still in some kind of a funk since Covid — make it a point to connect more completely with your loved ones. Just do it — pick up the phone — you are free to meet with people for now. Take advantage of that.

4. Practice gratitude.

Realize that the glass is not still empty — practice gratitude to put things into perspective.

Furthermore, gratitude can make you happier and improve your relationships. It may even help reduce physical ailments. These include headaches, gastrointestinal problems, and respiratory infections.

And, when it comes to being grateful — there are several ways to go about it. The most obvious would be writing in a daily gratitude journal. But, you could also send someone a ‘thank you,’ paying compliments to others and viewing each day as a new opportunity. Going for a walk outside and reflect for a moment at the end of the day and write down your wins.

5. Make time to play.

Your “play” doesn’t have to be like when you were a kid in school literally. But, scheduling time to play can give you that much-needed mental boost since it reduces stress hormones and releases endorphins. Additionally, it can make you more creative by encouraging problem-solving.

What counts as play? Anything. Board and video games, kicking a soccer ball around the backyard, puzzles, coloring, and singing are considered to play. If you can call someone to come over — do it. Our office has started to play pickleball every day at lunch and for an afternoon break. We invite other offices to join in our “tournaments.” It has been so refreshing. After such a long quarantine, sometimes we forget to get other people to come. If this is you — mark it on your Calendar or set an alarm.

6. Reduce screen time.

Now that the pandemic is over — determine to limit your screen time. Get outside and do stuff, especially since it’s summer and we can. Make a list and go do everything you dreamed about when you couldn’t get out. It is amazing how many great things are out there that are free or of little cost. But you can’t get out and do extra things if you are glued to the TV.

I’ve also established tech-free zones in the house. And, before listening to podcasts before bed — go back to reading books. You’ll be amazed at how well you sleep.

7. Focus on what you can control.

How to let go of control is no easy feat — especially for entrepreneurs. But, if there has been one key takeaway from the coronavirus, it’s that no matter how much you demand it — there are plenty of things in life that are out of your hands.

Right now, you can do things like getting on a plane, host a party and even go to a concert or sporting event. So go do each of those things. It is amazing how quickly you will perk up and be more productive.

If you are back at the office — go out and get some plants (all our office plants died). So we all went out and picked plants for the office together at a nursery — because we could. Also, get some new pillows for the office couch out front.

8. Stop worrying about being productive.

We live in a world where we obsess about being productive. And that can be problematic. Being “on” 24/7 and trying to maximize every minute of your day can make you anxious and exhausted. So to be productive and motivated — keep yourself fresh with new ideas and thoughts and do something fun.

If you feel up to getting things done, go for it, work fast and do it. On the other hand, if you are lagging in your new “back to the office” zone, give yourself a break — you’ve been through a lot.

9. Be aware of red flags.

Finally, pay attention to your grief if you have it. Don’t swallow! But pay attention to the red flags. Has your alcohol consumption increased? Are your sleeping or eating patterns different? Do you feel hopeless? If any of these things are still bugging you since the end of covid — look for a way to pull yourself out of it. It sounds cliché — but eat right, sing, dance and exercise. Ask around what others are doing, or if someone feels the same way you do.

If you answered yes to any of the above, then please seek help immediately. You can start by talking to your spouse, partner or best friend. But, you may need to reach out to a mental health professional. Please do this sooner than later so that you can move forward.

Complete Article HERE!

Death Doulas Adapt to Pandemic to Provide End-of-Life Support

COVID-19 prompted virtual visits, more interest in ‘death coaches’

by Robin L. Flanigan

Most Americans say they’d prefer to die at home, and indeed rates of home deaths are on the rise — a trend that may be fueled by the coronavirus pandemic and decreasing nursing home occupancy rates.

But having someone help navigate that end-of-life experience can be essential. Sometimes called a death coach or a death midwife, death doulas act as advocates for the dying, guiding everything from logistical preparations, such as advance care planning and funerals, to incorporating cultural and religious beliefs into final rituals.

“It’s kind of like being an event planner, but for death,” says Virginia Chang, a certified end-of-life doula in New York City.

COVID-19 has forced death doulas to adapt to pandemic restrictions and to new client needs. Those in private practice have had to offer more support over the phone and via Zoom, Chang says. At the same time, given a shortage of home care services, doulas have found themselves providing increased emotional support to caregivers, who may feel isolated or overburdened.

Virtual visits were an adjustment for Chang, who provides services through her business, Till the Last. “I do miss the intimate connection established between myself and the dying person through quiet conversation, presence and touch,” she says. “However, I have always said that empowering the caregivers to better care for their dying loved one meets my goal of better care for the dying person. So, I’m still doing my job.”

Chang has also noticed that patients and family members are getting in touch earlier than usual. Instead of being summoned weeks, or even days, before death, she is being contacted months, and sometimes years, before an anticipated death.

“They want to be better prepared,” she says. “By being better prepared, they’re better able to face death when it comes.”

Death doulas a ‘missing piece’ in care

Home has surpassed the hospital as the most common place of death in the United States for the first time since the early 20th century, according to a New England Journal of Medicine study published in 2019 (months before COVID-19 hit the U.S., which means that the number of home deaths is likely higher now).

Studies have shown that approximately 80 percent of Americans would prefer to die at home if possible, according to the Stanford School of Medicine. That figure may be higher now, after the pandemic focused people’s attention on death and dying, but COVID-19 has certainly amplified interest in the role of death doulas, says Henry Fersko-Weiss, 73, a licensed clinical social worker who, in 2003, created the first formal end-of-life doula program in the U.S., at a New York City hospice, and cofounded the International End of Life Doula Association.

“The recognition that death can be done differently is increasing because there’s been so much talk about death and dying,” he observes.

Though the work that death doulas do has probably gone on for thousands of years and been called different things, Fersko-Weiss says, the death doula movement gained steam two decades ago, offering meaningful services to those who felt limited by a traditional medical system.

“End of life needs more than crisis intervention,” he says. “This is a missing piece during a very demanding time in people’s lives.”

Fersko-Weiss cautions that people who are interested in working with a doula should know that no industry standards currently exist and that a certification by one organization doesn’t hold the same value as a certification by another.

Chang, for example, learned about end-of-life doulas after attending a talk that Fersko-Weiss gave. She has since been trained by the International End of Life Doula Association, the University of Vermont End-of-Life Doula Professional Certificate Program and the Visiting Nurse Service of New York.

Ask plenty of questions

Doulas support the dying, but they also provide services to those left behind.

Arlene Stepputat, 67, volunteers as a project manager for the nonprofit National Hospice and Palliative Care Organization’s End-of-Life Doula Advisory Council. The council’s Doula Grief Project, which offers free and confidential grief support services to those dealing with loss, grew out of the COVID-19 restrictions and the fact that most doulas couldn’t work in person with clients and families.

Experienced end-of-life doulas, trained in compassionate listening, provide one-hour telephone or videoconferencing sessions over four weeks as normal support systems continue to be taxed.

People who are considering the services of a death doula should ask plenty of questions, advises Stepputat, owner of Dying in Grace. “Interview that person like you would any other person you’d be making a contract with,” she says.

The National End-of-Life Doula Alliance offers an online state-by-state directory of doulas.

Some questions to ask a death doula are:

  • What is their experience?
  • What do they charge?
  • Where were they trained?
  • Why do they do this work?

Stepputat, who lives in Santa Barbara, California, was drawn to this occupation because of multiple losses: Four days before her 12th birthday, her father died in an accident; when Stepputat was 19, her girlfriend was murdered; and several street youths she worked with as a young adult died from suicide and other causes.

“Choose wisely because you are going to use this person in one of the most challenging times of your life,” Stepputat says. “It can also be one of the most sacred and beautiful times of your life. Creating a peaceful transition for someone you love is a gift.”

And the benefits of a doula-patient relationship go both ways, according to Terry Bonebrake, 58, of Grand Rapids, Michigan, a death doula who says she reaps rewards from her work.

“Anytime you do service work, your focus is on the other person, and yet you learn things you might not ever have known otherwise,” she notes. “What’s probably affected me the most is seeing how much every moment counts. This 60 minutes and the next 60 minutes will never be the same again.”

What do death doulas do?

Doulas “inform, support and guide, rather than advise or do,” explains Merilynne Rush, who offers end-of-life doula training, mentoring and certification through her consultancy, The Dying Year. Rush says end-of-life doulas can:

  • Help form a circle of support and find tasks for those who want to help.
  • Conduct a life review: Record stories, make a video or write letters to loved ones for future occasions.
  • Provide hands-on nonmedical comfort, such as guided imagery, breathing and relaxation techniques, hand massage and essential oil therapy
  • Sit bedside so family and caregivers can rest.
  • Pray; meditate.
  • Offer active listening.
  • Share information about local resources, like hospice and palliative care.
  • Prepare meals and do light housework.
  • Discuss wishes for end-of-life care (advance care planning).
  • Help arrange for (or keep) vigil during active dying.
  • Share information about home funerals, green burials and body care after death.
  • Offer grief support and ongoing visits after the death.

Complete Article HERE!

Planning Death Has Gone Digital

— Inside the Apps That Prepare You for Loss

Since the start of the pandemic, more people are downloading apps that help users process grief.

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Lucy Clay, 26, was at work when her phone buzzed with a message from her mother. Her dad was seriously ill, and doctors had raised the possibility of discontinuing treatment. Lucy was thrown into a cycle of anticipatory grief – and she turned to technology to help her with the waves of anxiety that she was experiencing, and to prepare herself for the next stage of her father’s palliative care. 

“It’s been incredibly comforting to know that there is a resource that you can access anytime you need it, day or night,” she told Observer. “When things are really bad, I can’t bear the thought of having to explain what is happening. There’s no substitute for having a human sit with you in the horror, but sometimes the silence of technology is a welcome alternative to the well-intentioned friend.”

For Lucy, who is herself a funeral director, the idea of death is a part of everyday life. Yet her career could never prepare her for the reality of caring for a terminally ill parent. After all, losing a loved one is an overwhelming experience. Family members and friends are often expected to deal with the vast administrative burdens that come with death at a time when they desperately need to grieve. And although death eventually comes for all of us, a surprising number of people have no real plan in place for when the end of their life approaches. Data suggests that although 90% of Americans think that talking to their loved ones about end-of-life logistics is important, only 27% have actually done so.

Enter the end-of-life industry. Over the last few years a plethora of apps and services, like those used by Lucy, have sprung up that promise to ease the process of planning for death. Whether it’s noting what healthcare that you’d like to receive, recording memories so that a curated legacy is left behind, or uploading important documents, there are plenty of options on offer. Some target a specific aspect of the death planning process, such as Safe Beyond, which allows users to record messages for the people that they leave behind to access after they pass. Others, such as leading end-of-life planning app Cake, offer a more rounded approach, guiding individuals through everything from writing a will to planning an eco-friendly funeral.   

Lucy now uses a range of apps that provide solace in an incredibly difficult time and help her to understand how best to manage a parent’s end-of-life journey. For her, the timing of technology’s increasing popularity when it comes to grief and end-of-life care was crucial. She describes the experience of looking after an extremely sick parent as feeling forgotten about – services and contact with care teams was limited due to COVID restrictions, and she found herself finding comfort, information and community in digital spaces instead. It’s a pattern that’s been seen across the industry, as online apps and services have seen a boost in their subscriber base over the course of the pandemic.

Liz Eddy launched end-of-life planning app Lantern in 2019 after struggling with the death of several family members. Months later the pandemic hit, and Eddy found that the app was flooded with users, an increase of 450% within two months. 

“It was bizarre timing,” she says. “Obviously, we had absolutely no idea that the pandemic was coming, but within a month of launch we were starting to hear about COVID.”

What surprised Eddy the most about her inflated user base was that most new sign-ups weren’t people approaching the end of their life, or even at an age when individuals usually start to consider making plans for their death (only around 14% of Americans under the age of 30 currently have a will). In fact, the Lantern team found that the majority of new members were between the age of 25-45, a much more significant proportion of their user base than they had seen pre-pandemic.

“People are aware of their mortality and the need for pre-planning, but very few people actually do it,” she explains. “Something like COVID gives people an immediate reason… it’s a reminder of how unpredictable life can be.”

Someone who is finely attuned to how important technology can be when life takes an unpredictable turn is David Kessler. David lost his twenty-one-year-old son suddenly several years ago and found himself embroiled in a logistical nightmare when trying to close his late son’s bank account. He discovered Empathy, an app that claims to streamline end-of-life bureaucracy and promises to automate some of the more complicated aspects of the post-death process. David, who now works as a grief expert, was so impressed by how technology could reconfigure end-of-life planning and processing that he ended up joining the Empathy team, where he now works as the Chief Empathy Officer.

“There’s no denying that COVID has made grief a more prevalent topic,” he says. “Loss has no demographic. It affects everyone at some point in their life… technology can’t promise to take the pain away, but it can hold your hand through the process whilst also offering guidance in the often unknown terrain of grief.”

In a world where much of our lives take place online, it seems only natural that death should find its own digital niche. The pandemic has boosted an already burgeoning industry, causing younger generations to reflect deeply on what they want to leave behind. Mark Taubert, a palliative care doctor who has been working throughout the pandemic told us how apps can prompt his patients to think about preferred places of death or make their wishes known ready for when they are too unwell to communicate. He describes the relationship between technology and end-of-life care as deeply complex, acknowledging that the way that we manage grief is influenced by the people around us, society, and our own experiences – and that the pandemic has been crucial in prompting us to consider how technology might play a part in both life and death.

“Technology can nudge us into asking the right questions about what we’d want towards the end-of-life, but it can’t help us answer those essential questions,” he says. “There are sites, videos, and apps that talk very openly about choices we might face at the end of our lives, and it seems like these are prompting people to take control and actually tell their clinicians what they would and wouldn’t want. I hope that technology pushes us further into that openness and peer-supported patient empowerment.”

For Lucy, who is now living with her parents so that she can play a more active role in her dad’s care, the support of her colleagues and family has been crucial, but she says that without technology she would have felt “a whole lot more lost”.

“Technology and apps help me sit in the waves of anxiety that come with knowing that someone you care about is suffering,” she says. “Sometimes I feel like I’d do anything just for some rest from the distress. In a time when most of my usual relaxation and distractions techniques have failed me, technology has helped me to find solace.”

Complete Article HERE!

Love, loss and pandemic puppies

Stephan Pastis’s tribute to his dog, Edee.

By Bonnie Jean Feldkamp

My daughter got Bella at her dad’s house shortly after the divorce. My ex even called the sweet yellow lab “the divorce dog.” Visits with dad also meant time with Bella, which was great when my daughter was 8 years old, but the teen years brought work, band practice and a social life. Visitation with dad became more sporadic. Then, my ex asked if we would dog sit. Bella was a senior dog by then, and we were all smitten. We asked if we could just keep her. He said yes.

Bella and I bonded in a way I hadn’t anticipated. I worked from home, and she was my constant companion. My daughter grew up and moved to an apartment of her own, but Bella stayed with me.

COVID-19 brought with it a puppy boom as people sought comfort and companionship during quarantine and isolation — but for me, Bella was there. We took walks in the woods and played in the yard with my son. Our circle got smaller as the pandemic began to rage. Schools closed, my husband was furloughed, and then, just as everything shut down, we had to say goodbye to Bella. That stacking of hardships is known as collective — or cumulative — grief, and I wasn’t sure I could take it.

One day in April, I woke up to find that Bella couldn’t even raise her head from her bed. Something was seriously wrong. I debated on rushing her to an emergency veterinarian but knew, due to COVID, I would have to watch her disappear into the building and not return. I knew this was her end. I made her comfortable and placed a video call to my daughter so she could say her goodbyes.

Every time we welcome a pet into our lives, we also welcome the inevitable heartbreak. We know how it ends, and yet we still open our homes and our hearts to four-footed companions.

Bella died at home in her bed while I sang her lullabies.

Anticipatory grief is the price we pay for unconditional love. Pets have seen us at our worst and our most embarrassing. They bear witness to everything in our lives without judgment. “That’s unprecedented emotional intimacy,” says Rachael Nolan Ph.D., MPH, CPH, public health educator and grief recovery specialist. Sure, pets can be moody sometimes (I’m looking at you, George the cat) but for the most part, their behavior is pretty predictable, which also provides us a source of stability. Nolan says stability is “one of the most important things in life for humans, particularly in regards to emotions.”

Isolation and quarantine during the pandemic deepened bonds and strengthened connections to our pets. Then, to have to say goodbye … it’s just devastating.

I began applying to adopt senior dogs. I’d fall in love with an online profile, only to be upset when the dog found a home with someone else. Pet adoptions soared last summer, making the high demand and the long wait heart wrenching. On one particular hot mess of a day, I sobbed over another dog I’d never met. I really missed my Bella. Adopting another dog wouldn’t fill that void. I withdrew my application from the local stray adoption program and gave myself time.

Then, one September day, my friend texted me about a litter of puppies needing homes. “I could pick up two and bring you one,” she wrote.

I said yes. She wasn’t an old Labrador like Bella — she was a mutt puppy who licked my face and chased my son while he squealed with delight. We named her Hamilton. I know I’ll have to say goodbye in a few years, but I’m grateful she’s here now, and I’m here for all the belly rubs she can handle.

Complete Article HERE!

Understanding Grief Therapy and How It Can Help

by Sara Lindberg

We’ve surpassed 600,000 COVID-related deaths in the United States, and many people are grieving a loss related to this pandemic.

Whether you’re dealing with a pandemic-related loss or grieving a loss related to something else, finding a way to cope is critical.

Grief counseling may help people of all ages process and cope with their feelings after experiencing a loss.

In this article, we look at how grief can affect you, the stages of grief, and how therapy for grief can help.

Therapy for grief, or grief counseling as it is often called, is designed to help you process and cope with a loss — whether that loss is a friend, family member, pet, or other life circumstance.

Grief affects everyone differently. It also affects people at different times. During the grieving process, you may experience sadness, anger, confusion, or even relief. It’s also common to feel regret, guilt, and show signs of depression.

A licensed therapist, psychologist, counselor, or psychiatrist can provide therapy for grief. Seeing a mental health expert for grief and loss can help you process the feelings you’re experiencing and learn new ways to cope — all in a safe space.

Grief generally follows stages or periods that involve different feelings and experiences. To help make sense of this process, some experts use the stages of grief.

The Kübler-Ross stages of grief model, created by Elisabeth Kübler-Ross, was originally written about people dying, not about people grieving, but later, she wrote on applying the principles to the grieving process after a loss.

There are five stages of grief under the Kübler-Ross model. These include:

  • Denial. After the death of a loved one, it’s not uncommon to be in denial about what happened. This can help temporarily protect you from the overwhelming emotions that come with grieving.
  • Anger. You may find that you are angrier than normal and direct your emotions at other people, including the person who died. It’s also possible to direct the anger toward yourself.
  • Bargaining. When you move out of denial and anger, you may find a period where you create a lot of “if only” and “what if” statements.
  • Depression. This is often called the “quiet” stage of the grieving process. You may experience overwhelming feelings of sadness or confusion. It’s common for your emotions to feel heavy during the depression stage, and you may want to isolate yourself from others.
  • Acceptance. When you get to a point where you accept what happened and understand what it means in your life, you’ve reached the acceptance stage.

Over the years, some experts expanded this model to include seven stages:

  1. shock and denial
  2. pain and guilt
  3. anger and bargaining
  4. depression
  5. the upward turn
  6. reconstruction and working through
  7. acceptance and hope

It’s important to note that the empirical evidence to support the stages of grief as a model is lacking, and, according to a 2017 review, some experts believe it may not be best when helping people going through bereavement.

Kübler-Ross’s model was, after all, written to explore the stages that people who are dying and their families go through, not for people to use after death.

One positive outcome of this model is that it emphasizes that grief has many dimensions, and it’s perfectly normal to experience grief through many feelings and emotions.

When grief is long lasting and interferes with daily life, it may be a condition known as prolonged grief disorder. According to the American Psychological Association, prolonged grief is marked by the following symptoms:

  • pervasive yearning for the deceased
  • difficulty accepting the death
  • intense emotional pain
  • emotional numbness
  • feeling like you’ve lost a part of yourself
  • persistent depression
  • withdrawal from typical social activities

In general, this type of grief often involves the loss of a child or partner. It can also be the result of a sudden or violent death.

According to a 2017 meta-analysis, prolonged grief disorder may affect as many as 10 percent of people who have lost a loved one.

Finding help for grief

Seeking therapy after a loss can help you overcome anxiety and depression by processing your experience at your own pace.

Each mental health expert may utilize a different approach to help patients tackle grief, and cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) are two methods often used for bereavement.

Cognitive behavioral therapy

CBT is a common treatment approach for mental health conditions like depression, anxiety, and post-traumatic stress disorder (PTSD).

During a CBT session, the therapist will help you identify negative thought patterns that can affect your behaviors.

They may ask you to explore thoughts related to grief and loss or other unhelpful thoughts to address how these thoughts affect your mood and behavior. They can help you lessen the impact with strategies such as reframing, reinterpreting, and targeting behaviors.

Acceptance and commitment therapy

ACT is another method that may help with grief and loss.

According to a 2016 research paper sponsored by the American Counseling Association, ACT may also be helpful with prolonged, complicated grief by encouraging clients to use mindfulness to accept their experience.

ACT uses the following six core processes for grief counseling:

  1. Acceptance of negative emotions. This step involves a willingness to experience and accept negative emotions and thoughts.
  2. Cognitive defusion. This process involves distancing from emotions so that it’s easier to examine and understand them.
  3. Contact with the present moment. By teaching mindfulness, ACT encourages people to focus on the present as that is when change is possible and when you experience life.
  4. Self as context. This step involves observing yourself having your experiences or becoming an observer of the experiences in your life.
  5. Values. These are the principles you hold that help direct your life.
  6. Committed action. The culmination of ACT, this step involves taking action and overcoming obstacles by working through the previous steps.

Grief counseling for children incorporates many of the same elements as counseling for adults, but the therapist works in ways that are appropriate for children.

According to the American Academy of Child and Adolescent Psychiatry, children, especially younger ones, react differently to death than adults.

In general, preschool-age children see death as temporary and reversible, but kids ages 5 through 9 think slightly more like adults. Some common ways grief counselors treat children include through:

  • Play therapy. Play therapy uses a child’s most instinctive behavior of interacting with the world around them by playing. A therapist may use dolls, puppets, stuffed animals, a dollhouse, or other toys to encourage the child to communicate thoughts, feelings, questions, and concerns they may otherwise struggle to express in talk therapy.
  • Art therapy. Art therapy allows a child to express themselves creatively and without words. A therapist may ask a child to draw or paint a picture of the person they are grieving and then use it as a way to explore their feelings.
  • Narrative therapy. Several children’s books deal directly with death but in a child-centric way. A therapist may use books to help a child understand death and dying and what can happen moving forward.

Things you can do to feel better if you’re grieving

Self-care is a critical component of the grieving process. In addition to participating in therapy, consider things you can do to take care of yourself. Here are some ideas to get you started:

  • Stick to a daily routine.
  • Get physical activity daily.
  • Eat a healthy diet.
  • Restrict or avoid alcohol.
  • Practice mindfulness meditation.
  • Spend time with friends and family.
  • Incorporate at least one thing in your day that brings you joy.

It can be difficult to quantify or predict the outlook for people dealing with grief, especially since each person manages it in their own way. It’s also challenging to predict if any one treatment may work the best.

Grief does not follow one particular path. Healing is unique to each individual, and the outlook for people dealing with grief looks different for each person.

A therapist can play a key role in supporting the healing process by facilitating counseling sessions based on your situation.

Complete Article HERE!

This is what ‘tree burials’ are like in Japan due to lack of space in cemeteries

by

The families place the ashes on the ground, and plant an endemic species, forming forests in memory of the deceased.

Funeral rituals have accompanied human beings since they have notion of self. The earliest recorded burial is in Kenya, dating back 78,000 years. It is one of the oldest indications we have of a transcendence-oriented thinking: to the possibility that there is something beyond our earthly understanding.

With the advance of urbanization, and the apparently irreversible trend of population growth on the planet, the spaces to deposit the organic remains of the people has been compromised. We no longer fit. Given the situation, burials in Japan have had to take a new direction, which affects less the environment and appeals to a contemplative sense of eternal rest.

Rest in the shade of a tree

Natasha Mikles has dedicated her life to exploring the alternatives that exist to face death in the world. With the climate emergency in tow, the expert in philosophy from the University of Texas considers that the appropriation of physical land in favor of funeral practices it is simply no longer an option.

In recent years, Mikles has focused his study on Buddhist funeral rituals and narratives about the afterlife. In these Asian traditions, death is not understood as an end point. Rather, it is one more phase of the wheel of karma, and a step forward in the path to enlightenment.

Many times, however, the author acknowledges that “environmental needs collide with religious beliefs“, As detailed in his most recent publication for The Conversation. Rest perpetually under the shade of a tree in a public green area it could be an option, as is being seen in burials in Japan today.

A new way to face death

burials in Japan

It is not the first time that burials in Japan have been practiced in this way. Since the 1970s, there has been a record of Japanese public officials fearing for the lack of funeral space for the population, particularly in urban areas. The problem deepened in the 1990s, when more serious alternatives began to be implemented throughout the island.

It was then that Jumokusō was thought of, which translates into Spanish as “tree burials.” In these, the families place the ashes on the ground, and plant an endemic species on site to mark its final resting space. In this way, instead of building more cemeteries, entire forests would be planted in memory of the deceased.

This principle leans from the Shinto tradition, which finds value in all the vital manifestations of the universe. For this reason, the spaces dedicated to this type of funeral rites are considered sacred: there is an intrinsic spiritual value in life that ends to make way for a new.

We suggest: Natural organic reduction: this is what ecological burials are like that turn your body into human compost

Do burials in Japan of this type interfere with traditional practices?

burials in Japan

Many of the families that have implemented this strategy of sacred greening of public spaces they don’t even practice Shintoism, or are affiliated with a specific religious tradition. However, the interest in continuing this type of practice denotes a environmental responsibility extended throughout the population.

Despite this, these burials in Japan also obey an ancient Buddhist principle. Like the plants are considered sentient beings, it is a way to continue the reincarnation cycle for the soul that departed. Seeds embody a living component of this path, and therefore, they must protect themselves with the same honor.

The practice has been so well received that various temples and public cemeteries have adopted it as part of their agenda today. The model has been so successful that some Religious spaces promote it as part of the spiritual life of people. Although they do not necessarily align with the ancient practices originally proposed by Buddhism, they do obey the precept of respect for existing forms of life, which sets the standard for all branches of this spiritual tradition.

Complete Article HERE!

What the Pandemic Taught Us About the End of Life and Grief

Hospice workers, ethicists and therapists say grief is a pathway toward healing

By Vicky Diaz-Camacho

Grief felt “closer” this year for Meagan Howard. It’s the only way she could describe it.

On May 16, her good friend died in a car accident. There was something different about this death. As a Black woman in the mental health field, Howard said she has personally felt the compounding trauma of the pandemic with racial tensions.

That’s why it hit harder.

But as she sat in silence and cried with another friend to mourn their loss, she felt the release.

“That was more healing than someone saying, ‘It’s going to be OK’,” she said.

Meagan Howard
Meagan Howard is transparent about her own difficulty to grapple with grief and now encourages others to find ways to navigate sometimes complex emotions.

Years ago, Howard personally struggled to acknowledge the grieving process when her grandmother died. Now, she works against that to help her own clients who are navigating complex feelings of anger, avoidance and sadness — symptoms of grief — and in her personal life.

She specifically counsels folks with substance use disorders at Midwest Recovery Centers, which can often stem from unresolved trauma and loss.

The pandemic sparked a new kind of uncertainty, ranging from housing and job security to health security. This is why it’s more important now than ever to take a moment to pause and feel, she added.

A paper for the National Institutes of Health (NIH) on preparing palliative care providers explained that “anticipatory grief is the normal mourning that occurs for a patient/family when death is expected.”

That anticipation evaporated in the wake of the public health crisis. Back in March 2020, the number of people infected and dying from complications skyrocketed. This, mental health experts say, caused a mental health whiplash.

“As a society, we’re just kind of told lock it down, keep it moving,” she said.

However, she witnessed a shift this year that ranges between communal trauma to communal grief.

Howard said grieving as a society has been an essential step toward collective healing.

“One of the most powerful things that I saw from the pandemic is this sense of community,” she said. “There is power in being able to share your grief in a community setting with someone else. (It) gives us power when we feel like we don’t have any.”

From a mental health perspective, grief is healthy.

“It’s needed, it’s necessary, it’s essential,” Howard said.

“If we’re not allowing ourselves that grieving process, then almost in a sense we almost start to die internally. And I know that sounds kind of morbid, but that’s what it feels like is happening if we’re not allowing that to come out.”

Researchers at the NIH outlined what they call “context of grief” during the pandemic, which underscored how the public health crisis complicated an already sensitive process.

The study identified three specific changes during COVID-19: spread of the disease; social distancing and the increase of deaths; and hospitalizations and overburdened hospital systems. It outlined the financial, emotional, social and mental toll this would take on society at large.

Among the recommendations was to address grief head-on:

“Approach difficult conversations directly and do not shy away from discussing emotions, grief, and overall patient and family distress during advance care planning conversations.”

Trauma and loss experts have long advised families to begin conversations early about advance care planning. The idea is to ease ourselves into more comfortable conversations about what to do when someone we love dies. More importantly, these conversations serve as an emotional buffer.

Caring Conversations

Life unexpectedly changed, leaving communities unsure how to grapple with uncertainty and at the same time inciting communal trauma of seeing folks die from COVID-19.

This brought to the surface ethical considerations that impact the grieving process. How do families broach the subject of advance care planning or Do Not Resuscitate (DNR) orders?

That’s where Terry Rosell comes in. Rosell is an ethics consultant at the Center for Practical Bioethics — one of the only three centers of its kind in the United States.

(Disclosure: the author’s spouse recently accepted a job at the center. The interview was arranged and conducted without their involvement.)

Rosell, who is also a faith leader, works closely with medical professionals and has seen firsthand how COVID-19 changed the way in which families and their doctors approach life and death discussions.

Terry Rosell
Terry Rosell is an ethics consultant and educator for the Kansas City University of Medicine and Biosciences and the University of Kansas Medical Center. He also was a theology professor.

“It’s hard enough to die. It’s hard enough to deal with our loved ones dying. So we ought to make it better,” he said.

End-of-life care is also known as hospice and palliative care, which emphasizes keeping the person comfortable while they’re dying. This is part of what Rosell teaches when he presents to physicians and hospital staff.

“The first ethics matter around end-of-life care is taking care of these patients. Just because they’re no longer curative, just because they’re no longer receiving aggressive care, we still have a duty to care for them,” he said. “We ought not to abandon dying patients, right?”

Another part of his job is educating on advance care planning, which ensures a person’s wishes are fulfilled. To some extent, this practice can curb the anxieties that come with anticipating loss.

But not everyone may know what hospice care or advanced care planning entails, which brings to the forefront the lack of visibility of end-of-life services. What the pandemic revealed was the need to address these conversations earlier on.

This helps with the processing part of loss, Rosell explained. Death is a part of life and grief follows suit.

“Any kind of significant loss has a grief response. It’s just part of being human,” he said.

Part of being human is finding comfort in some sort of routine, whether that be spiritual or a ritual. To that end, Rosell added: “Don’t give up on the grief rituals during COVID times. It helps us”

‘I don’t know who I am anymore’

For Oscar Orozco, being vulnerable is part of his job.

Orozco was a former medical social worker for Children’s Mercy, where he helped at-risk children. Today, he works as a grief counselor at Kansas City Hospice and Palliative Care. He echoes Rosell’s points on advance care directives to reduce the added stressors of planning while someone is on the decline.

Oscar Orozco
Oscar Orozco, a grief counselor at Kansas City Hospice and Palliative Care, sees grief as an unpredictable wave.

Even though he’s been in his new role for a short few months, the need for counseling folks through the process has never been more clear.

This year hardly anyone has been able to catch their breath. Orozco said he has talked to health care workers who are friends or clients and they said: “I can’t do this. It’s too much.”

Why?

“(There’s) death and traumatic death, and it’s different. This is not death that people could see coming,” Orozco explained.

Another piece of complex trauma is identity and how folks have struggled to come to terms with the absence of their loved ones.

“In our grief work, what I hear almost often is, ‘I don’t know who I am anymore’,” he said. “People don’t realize that it’s much more than just the death of that person, but it’s the death of … routines, of day-to-day activities and memories and parts of our lives really that died with that person.”

He sees grief like an ocean. It’s unpredictable but sooner or later it’s easy to know when the waves are coming. Managing grief is like swimming, he explained, and sooner or later, we learn how to stay afloat.

Oscar Orozco with his grandparents
Oscar Orozco (middle) lost his grandfather a few months ago. He’s since learned how to process the loss by channeling his grandfather’s love of food into his own life.

That’s how he feels about the recent death of his grandfather. He channels his emotions into cooking, which is how his grandfather expressed his love for the family. This physical act helps him emotionally recover and process.

Processing is key, he said, but that’s been on the back burner for so many during the pandemic. So he advises folks who have experienced loss to be active and deliberate in the grief journey. That could mean going to their burial site for a visit, or it could be to buy their favorite meal from their favorite restaurant.

Grief is an individual process. Orozco advises people to embrace the emotion whether it be by crying, journaling, hiking or traveling.

“You know, whatever it is that comes out naturally to express, but never cast it aside because we’re afraid of where it might lead,” he added.

“We need to talk about this. We need to have those conversations because as uncomfortable as they might be, they could be lifesavers for (us) to continue to live our lives in a meaningful way.”


5 Tips on Navigating Grief

  1. Grief can be complicated and hard to pinpoint. That’s OK. Acknowledge the feeling or sensation (it could be a stomach ache, fatigue, lack of focus or emotions such as profound sadness or anger) as a first step. Experts say there are several kinds of grief:
    1. Complicated grief: When loved ones ruminate about the cause of death, worry about the consequences, feel guilty and display avoidant behaviors, such as denial. Around 7% of bereaved people will experience this kind of grief.
    2. Disenfranchised grief: When a loved one loses a person or child. It “can occur when families are unable to grieve with normal practices of social support and rituals in burial and funeral services,” according to the NIH.
  2. Asking for help to begin the grieving process is OK. “Grief counseling can help,” said Terry Rosell at the Center for Practical Bioethics. “Ministers, clergy, rabbis, priests, there are a lot of people who can help with grief counseling (for free).” You can find grief counselors at your local hospice organizations and mental health professionals who specialize in loss — for good reason. One example is the Solace House Center for Grief and Healing.
  3. Communication is powerful. Talk openly with family members, chosen family or biological relatives, or friends about their wishes before death — sick or not. Studies on the psychological impact of meaningful conversations — or saying “goodbye” — among family members of cancer patients show it helps with depression and complicated grief.
  4. Engage in activities that remind you of your loved one. This can also be characterized as play therapy if your loved one was an artist, which eases the transition from grief to acceptance. “I very much believe that spiritual practices or just rituals is how we get in tune with what our body is telling us about the loss we experienced,” said therapist Meagan Howard.
  5. Cry. Therapists advise sitting in a safe, quiet place or with a support network to embrace the feeling and release. This is good both physically and psychologically. Crying is the body’s “release valve,” according to Dr. Judith Orloff, who wrote: “After crying, our breathing, and heart rate decrease, and we enter into a calmer biological and emotional state.”

Complete Article HERE!