Sadness and Loss Are Everywhere. Books Can Help.

By Margaret Renkl

I was 10 when “Brian’s Song” aired in 1971 as an ABC Movie of the Week. It is the story of the abiding friendship that grew as Brian Piccolo, who was white, and Gale Sayers, who was Black, competed for playing time as N.F.L. rookies with the Chicago Bears. It’s also the story of Piccolo’s death of cancer at 26. I was a girl in Birmingham, Ala., then “the most segregated city in America,” when “Brian’s Song” reminded this country that race was not an insurmountable barrier to love.

Of course I read “I Am Third,” the 1970 memoir by Gale Sayers from which the film was adapted, as soon as I could get my hands on it. When the bookmobile librarian suggested that I might also like “Death Be Not Proud,” John Gunther’s heart-wrenching account of his 17-year-old son’s death from a brain tumor, I devoured it too.

I was not a child obsessed with death; I simply wanted to understand how the world works. My friend Mary Laura Philpott read the same kinds of books as a child, and for the same reason.

“The more I saw and heard of the real world, the more I came to suspect there was sadness everywhere, and if I was going to live in this world, I should understand its scale and reach,” she writes in her acclaimed new book, “Bomb Shelter.”

Reading stories is a gentle way for a child to encounter the hardest truth that shadows mortal life: There are no happy endings.

“The first problem love presents us with is how to find it,” writes Kathryn Schulz in her new memoir, “Lost & Found.” “But the most enduring problem of love, which is also the most enduring problem of life, is how to live with the fact that we will lose it.” Many stories solve the first problem. Far fewer admit that the second even exists.

Books about loss tell us something about our own nature. They remind us that we belong to a species capable of carrying on when we think we can’t carry on any longer. Death is just part of how the world works. It’s part of how we ourselves work.

“No part of an embodied life is guaranteed except for death,” writes Tallu Schuyler Quinn in her new essay collection, “What We Wish Were True.” To face it — however haltingly or furiously or tearfully, or on a carousel of all those swirling feelings — is to be fully alive.

Ms. Quinn was the beloved founder of the Nashville Food Project, which addresses food insecurity. Last summer, when I wrote about her life and mission, she was working on a collection of essays drawn in part from her CaringBridge journal about living with a terminal brain cancer. Ms. Quinn died in February. The book will be published on Tuesday.

I did not know Ms. Quinn personally, but even from a distance I know that her life was a bright testament to the power of serving others. I know, too, that she could write like an angel, with poetry and humor and a bone-deep understanding of the way love and grief walk hand in hand through the world together, twinned: “As these tumors hold court in my mind and mix me up in these sad and terrible ways,” she writes, “I find shelter in new thanks and new praise and in another day — and even in how healing these salty tears taste pouring into my open mouth as I wail my thanks for this unexpected, unbelievable, boundless shelter of love.”

There are reasons to worry that a book which confronts the essential inevitability of death, especially the untimely death of a human being in love with the world, someone who never seemed to waste a minute of her one remarkable life and is heartbroken to leave it behind, will be a book many readers will fear to face.

After all, we are still in the midst of a pandemic that has taken millions of people from their loved ones. We are watching in real time as bombs fall from Ukrainian skies and Vladimir Putin’s ground forces slaughter innocent people. The hunger Ms. Quinn fought so hard to alleviate will inevitably worsen as inflation rages. In such a world, who could bear to read a book which the writer herself did not live long enough to see into print?

But the human world has always been just this tragic, just this unbearable, and the literary world has always given us reasons to understand the gifts such books can offer — not in spite of the tragedies we witness and live through, but because of them — if we don’t turn away.

We’ve all had near misses that shook us to the core: when a hydroplaning car skidded to a stop in the nick of time; when a toddler, unwatched for half a second, teetered at the top of a flight of steps but was caught just before stepping over the edge; when the scan showed a shadow that had to be a tumor but turned out to be nothing at all.

And every near miss is almost always followed by a golden time, too brief, when the futile frustrations and pointless irritations of daily life fall away, when all that’s left behind is gratitude. We are here. Our beloveds are here. How remarkable it is to be together. How full of grace the fallen world can be.

“What We Wish Were True,” like so many end-of-life memoirs that came before it, and so many others still to come, is for readers a kind of literary near-miss experience. Its beauty reminds us to linger in the grace. Its wisdom teaches us to treasure the ordinary pleasures we ought to have been treasuring all along.

“I think about everything I will miss, and what I won’t be alive to witness or experience or endure or bounce back from,” writes Ms. Quinn. “No singing show tunes in the minivan. No burnt toast with butter in the mornings. No snuggling up to watch cooking shows. No walks together circling the neighborhood we love so much.”

Whether it comes before or after we turn the last page of a book, we know the ending of every human story. “If an ending could be changed through strategic planning or force of will or the sheer love of life, things would go differently, but this cannot be changed,” Ann Patchett writes in “These Precious Days.”

It cannot be changed. The finality of that truth is breathtaking.

But “What We Wish Were True” is not a book about dying any more than “Brian’s Song” is a movie about dying. It is a book about the life of an extraordinary person. It is a book about love and gratitude and making every day an opportunity to love, a chance to decide, again and again, to keep on loving for as long as we draw breath. And, through the miracle of books, beyond it, too.

Complete Article HERE!

‘I’m living for both of us’: a love letter to my deceased best friend

When actor and comedian Katy Wix’s best friend suddenly died, she was plunged into grief. But five years later she reveals how his death has changed her for the better

‘I know exactly what he would think about himself dying and me being left behind, with all my half of our private jokes’: Katy Wix.

By Katy Wix

At first, I didn’t understand what happened to my best friend. We spoke on a Tuesday and then he was dead on a Thursday.

When I first met him, I was standing under the stairs of the maths block with another girl. He walked past and I said, “We’re contacting the devil, wanna watch?” He put down his bag and nodded. The girl and I took each other’s hands, closed our eyes and began slowly counting backwards from 30. When we got to 11, a teacher with bulging eyes said, “What’s going on here, then?” We quickly dropped our hands and I looked at my shoes and said, “We were contacting the devil, sir.” The teacher paused and said, “Well… don’t.” I was 13, he was 14.

As we said our goodbyes on FaceTime that Tuesday, we talked about how excited we were to watch the final series of Peep Show. There was always talk of future plans. He said he might train as a tattoo artist or look into becoming a Buddhist. I felt as though it was OK to stop worrying about him, for that day anyway.

His death changed me for the worse and the better. In the first few days and weeks, I had to learn how to survive. I now had this word “grieving” that people would understand and respect. I used it in emails and to leave conversations. When you are a functioning depressive, you are able to get by, but only just. And there is always this worry that maybe people won’t believe that you are struggling and need help, because your life isn’t falling apart. All that changed after his death. Now, I wasn’t able to function and I had to defer to the pain. I was forced to tell the truth about not being OK, in a newly vulnerable way. Before he died, I used to be embarrassed about my depression, and tried to keep it hidden.

I even kept it hidden from him. When I first moved to London, he stayed in Cardiff, but we would spend hours on the phone most evenings. My flatmate said she always knew when I was talking to him because of the laughter coming from my room. Escapism was a big part of our friendship.

He came to visit me and hated the tube and only wanted to go to Camden. We sat in the corner of a red pub that only played Oasis. Occasionally, between the giggling, a look passed between us and we would see in each other’s eyes that maybe we weren’t happy, but weren’t going to talk about it. Now, I wish we had. The only thing he said, as we spilled out on to the street, was that he found adult life “boring and uncreative”.

Most people I know struggle to take their own pain seriously, let alone talk about it. But loss is dangerous and some people don’t survive it. Now I was being honest about how I felt, I began looking after myself in a new way. I asked a friend to get me some cream for the mysterious rash that appeared all over my body, 24 hours after his death. I designated a horrible peach towel in the bathroom as the one I would silently cry into. It was softer and kinder on my eyes than tissues. I began to floss. I ate meals. I took my medication. I listened to an audiobook of The Tibetan Book of the Dead on full volume, even when I knew the neighbours had people over. I downloaded a meditation app and then deleted it to have more memory to play Cake Shop 2. I got a 2m-long phone cable so I could comfortably play it in bed without stretching.

I paused my never-ending projects of self-improvement (get Michelle Obama arms, read Middlemarch, give up Diet Coke). I couldn’t improve in any way or be productive. I could just survive. When getting out of bed was difficult, I broke things down into threes, to make them manageable: 1) push duvet off; 2) put feet on floor; 3) stand. This was the most I had ever done for my emotional wellbeing and I have my friend to thank for that. When you are the one hurting yourself, you are never safe. It was nice to start to feel safe in my own company again.

Whatever I did, I still needed him. And in those moments I had to turn to the living. I started to wonder if I had been cured of my lifelong shyness. Openly weeping in front of strangers was such a break from social norms that it was liberating. The shock was so great for so long, that it filled me right to the top, leaving less room for self- consciousness. I cried on trains, and didn’t try to hide it by wiping away the tears, so they pooled in my neck, making my scarf wet.

One day a friend, who was fresh in her grief, asked me what to do. I forgot that no one teaches us how to grieve, and that there are things I desperately wish people had told me. My friend was shocked to hear that anger is allowed, loneliness is extremely common, and the pain won’t stay at the same intensity. I wish someone had told me to not be frightened of the future, because I didn’t know that it wouldn’t stay as bad as it was on day one. I hadn’t realised that my experience could help others. This was my induction into a sort of club, each member of which has lost someone. I started to make connections and have conversations I never would have before.

Later that day, in Sainsbury’s, a woman with red eyes stretched her whole arm towards the back of a shelf to find the milk with the longest sell-by-date. As shoppers pushed squeaking trolleys past me, squinting in the artificial light, I wondered how anyone gets out of bed in the morning. My friend’s pain began to make sense.

When I went back to work to film a TV show, I was quiet and looked at my shoes a lot. At lunchtime, a slightly sexy older actor made intense eye contact with me, put his hand to his pec, and said, “First loss?” I was annoyed at how wise and fatherly he was being. For the rest of the day, he stared at me across the room with a look of concern and erotic sadness, like I was big, sexy grief baby that needed rescuing. I imagined a whole future with him in a handbuilt farmhouse, where he would write me a bad play about being sad and I would mend his plaid shirts with twine. When the job ended, I showed him a bit of my bra strap and pretended it was an accident. There was so much sympathy around for me now, and sometimes I wanted to indulge.

Eighteen months later, I was eating lasagne in front of Below Deck when I had the thought that I’ve accidentally become more set as a person. In grief, there isn’t time to want to be like someone else. Trauma means reacting in the moment, as you are. You have to be horribly yourself. Like in a novel where character is revealed through actions, crisis showed me who I was. I don’t always have to like what it shows me. I wear the clothes now that my mother would have hated, things that are too short or tight. I’ve dyed my hair dark, which she said was ageing, and I’ve grown it long, which she said made my neck look short. I’m much angrier now. It’s good as a woman to feel anger, because my mother pretended she didn’t have any and my father had too much.

Once you’ve been through loss, you know its landscape. All loss will remind you of the first loss, like it’s one big river of yearning. And I have become less shocked by it. At first you think you are nowhere, but if you’re lucky, you might feel as though you have travelled somewhere. It’s a very particular type of wisdom, a profound, mystical feeling of having seen the wild edges of being human. I’ve returned from a quest, changed, and have information to tell the other villagers.

Five years on, I understand more about what happened to my friend. I understand he was trying to protect himself from pain. I didn’t understand it when I was younger. It’s difficult when you are young and you come face-to-face with addiction. We all drank a lot, so it was difficult to detect. It was a slow build, like one long note, getting louder and louder. As teenagers, we’d spend afternoons sitting in his purple bedsit in Cardiff, sipping cheap rum and Coke, breathing in sharply as it stung the roof of our mouths and then we’d laugh and try to act sober on the phone if a parent called. Later, his drinking got worse, but I was too embarrassed to mention it. I saw it as a phase. I was waiting for the plot twist, where he suddenly reveals he had a plan all along, that the drinking was a way into something else, and a new, reformed person would emerge on the other side of the destruction. But it was just more of the same. And then it got worse.

Now, I get to write about him, which wouldn’t have happened otherwise. I wouldn’t have been able to write about going to my first concert with him, rolling down big hills in West Wales with him, taking hallucinogens and thinking we were made of milk, or how he was funnier than most professional comedians I know. Before, I was too shy to write, definitely too shy to write autobiographically, and now I can’t stop. I get to write about him even though there is a voice in my head, even now, telling me that it’s not good enough. It’s true: no writing will be good enough to represent him. And I’d trade all the words for him.

Ultimately, it has strengthened my love for him. He hasn’t taken the friendship with him. I still care about him and I know exactly what he would think about himself dying and me being left behind, with all my half of our private jokes. I’ve absorbed his traits. I eat the foods he liked and use words he liked and say our jokes to myself. And I’ve come up with some new ones for us, too. I’m living for both of us. I have replaced this person with love. And I get to write this love letter to him.

Complete Article HERE!

Why ‘Prolonged Grief Disorder’ Has Mental Health Professionals Split

By Ed Cara

The American Psychiatric Association last week officially introduced a new diagnosable mental health condition: prolonged grief disorder. The news, while welcomed by some clinicians and researchers, has also been controversial. At the heart of the debate is the long-running question of how to define suffering, as well as how best to help people cope with the inevitable reality of experiencing loss.

Prolonged grief disorder was codified in a revision to the APA’s fifth edition of the Diagnostic and Statistical Manual of Mental Health Conditions (DSM), though it was previously announced last fall. The basic definition of prolonged grief, according to the APA, is when someone experiences “intense longings for the deceased” that last longer and are more disruptive to a person’s daily functioning than typical grief. Specifically, prolonged grief should only be diagnosed in children if they’re still experiencing these feelings at least six months after a death or loss, and at least a year after for adults.

Some mental health professionals have been calling for the disorder to be added to the DSM for more than a decade. Their research has argued that a small percentage of people — perhaps under 5% of the population — experience feelings of grief that are profoundly different, longer-lasting, and much more harmful from the “normal” mourning we feel after the death of a loved one. What’s more, they add, this grief can be reliably distinguished through screening tools from other conditions that could arise or be triggered by loss, such as depression or post-traumatic stress disorder.

“So, it diverges from normal grief in its duration and intensity as well as in its impact on everyday life,” Maarten Eisma, an assistant professor in clinical psychology at the University of Groningen in the Netherlands who has studied the condition, told Gizmodo in an email.

But for as long as prolonged grief has been held for consideration in the DSM, there have been some professionals aghast at the notion of making it an official condition. Despite assurances from advocates, they fear that the diagnosis will undoubtedly blur the lines of how we talk about and manage grief in unhelpful ways.

“The criteria unfairly target a subset of grieving people to be diagnosed with a mental illness,” Joanne Cacciatore, a trained social worker, researcher, and grief counsellor for over 25 years, told Gizmodo in an email. “For example, the criteria states that at one year, you can be diagnosed with PGD if you are intensely yearning for the person who died. What parent would not yearn for a child who died? Intense emotional pain? After such traumatic losses, what person would not feel intense emotional pain one year later?”

Cacciatore’s own research with bereaved parents has suggested that a majority of them can experience the sort of symptoms that could result in a diagnosis of prolonged grief disorder or other psychiatric diagnoses up to four years after their child’s death. And if so many parents can feel this amount of grief that it’s considered not normal, she asks, then “perhaps it is the measures that are flawed, not the grievers.”

There has also been some data to suggest that the inclusion of PGD will further stigmatised those who are visibly having a harder time dealing with their grief than others. Eisma’s research has found that members of the general public reading vignettes were more likely to stigmatised people diagnosed with prolonged grief after a loved one’s death than they were after hearing about someone in a similar scenario who was not diagnosed with the disorder. Another study of his found a higher level of public stigma for PGD patients compared to those mourning the loss of someone to suicide, which has previously been shown to cause stigma in other studies.

“Compared to people with normal grief reactions, people judge people with severe grief more negatively, react with anger, anxiety, and pity towards them, and prefer to keep their distance from them. In as far as the diagnostic label PGD will gradually come to signal such severe grief reactions, we can expect such labelling to elicit stigmatisation,” he said. At the same time, he added, “many grief experts regard such stigmatisation as a necessary evil.”

There’s long been a tension about the meaning of illness in medicine, with prolonged grief disorder only the latest to spark arguments between practitioners. This debate isn’t simply academic. Insurance companies will rely on the DSM codes, as well as those from the much broader International Classification of Diseases (ICD), to decide whether to cover treatments for someone’s symptoms. So even if the criteria of PGD isn’t perfect or its validation could lead to some unintended consequences, advocates argue that its inclusion will at least allow some people with severe grief to get help that they otherwise wouldn’t have been able to access.

There’s something to be said about that need, according to Sheila Vakharia, a former clinical social worker and currently the deputy director of the Department of Research and Academic Engagement at the Drug Policy Alliance. But she argues that the diagnosis is far from a real structural solution, especially today. She notes that, in a world where thousands of Americans a week continue to die to an ongoing pandemic, how can anyone’s ongoing grief over the losses they’ve experienced be considered abnormal?

“For a diagnosis such as this to be released at this moment, it just feels tone deaf, and it feels decontextualised, both within the broader policy environment and with the fact that we are in a mass disabling and a mass death event — we’re in a global pandemic,” she told Gizmodo by phone. “I think in the midst of a global pandemic, there is a degree of what would be reasonable shock and disbelief that the conditions that allowed our loved ones to pass have been allowed to continue.”

For the foreseeable future, prolonged grief disorder is here to stay. Not only is it now in the DSM, but it was added to the ICD in 2018. There are already some dedicated existing treatments, like grief-focused therapy, available to those newly diagnosed with it, while Eisma is involved with several randomised clinical trials testing online forms of cognitive behavioural therapy. Elsewhere, researchers plan to test whether naltrexone, a drug used to treat alcohol and opioid dependence, could help those with prolonged grief — the theory being that severe grief may work along the same neural pathways as addiction.

Though Vakharia may have issues with PGD, she at least hopes it can shine a light on the greater forces that animate our collective grief, like the pandemic or the still worsening overdose crisis, as well as how we’re allowed to express it.

“If we’re gonna make protracted grief disorder a diagnosis, for instance, are there human resources policies and employment policies and school-based policies that we need to have, so people can have the space to even grieve during that window of time when it immediately happens? Because if we don’t give people enough space to experience the grief in the moment of the loss, then it never really goes away, and it compounds,” she said. “I think another issue is that we’ve all been told to keep moving. In terms of covid, in terms of the overdose crisis, there hasn’t been a lot of space for people to process and feel grief. Instead, there’s been so many calls for us to go back to normal, for us to go back to work, for us to not let so-called fear take over.”

For her part, Cacciatore argues that we shouldn’t have to settle for the best of an imperfect system and for imperfect diagnoses like prolonged grief disorder.

“The system is absolutely broken, and we need an ethical change. Psychological care should not be predicated solely on a diagnosis,” she said. And these reforms shouldn’t just extend to psychology but to our world in general, she added, in order to address the underlying factors that can lead to severe grief, like a lack of social support.

“We need better grief support education in our culture. We need more facilitators and facilities to care for people who are grieving — really care and support, without judgment or coercion — and we need an overhaul of the insurance payment system,” Cacciatore said.

Complete Article HERE!

Life after living

— pet-loss professionals help people work through their grief

By Tracey Tong

When her beloved golden retriever Shelle died of kidney disease, Sharon Van Noort didn’t get to make the final arrangements. “I wasn’t told where she went, and what was done with her body,” she says – just that she’d be taken care of. “Back then, it wasn’t acknowledged that families needed care too.” Without closure, Van Noort continues to grieve her companion – 33 years later.

“Taking the time needed to say goodbye, and having a veterinarian who truly understands the importance of the cherished pet, make a huge difference in moving forward through the grieving process,” says Faith Banks, a certified hospice and palliative-care veterinarian and pet-loss professional in the West End. “If grief is not processed and worked through, it sits and waits for the next opportunity to strike.”

Through the experiences of other pet owners, Van Noort found a way to right a wrong. Six years ago, Helen Hobbs, co-founder of the pet funeral service Pets at Peace Toronto, licensed her business and Van Noort opened Pets at Peace North in Orillia.

Faith Banks and Faithful Pet Memorial offer nose prints of deceased pets, as well as teeth, fur, paw prints and bags of ashes

“Making funeral arrangements can give closure, which is so important,” says Van Noort, who has 25 years’ experience as a respite provider in the children’s mental health field. Like Hobbs and Banks, Van Noort looks after bereaved families as much as she cares for their pets.

Banks, who founded Midtown Mobile Veterinary Hospice Services in 2012, heads an all-female team of 20 veterinarians, hospice-care coordinators and aftercare providers. She opened Faithful Pet Memorial, a division of MMVHS, in February.

Faithful Pet Memorial is the first Toronto facility to offer pet aquamation, a water-based cremation process that, Banks says, has become “increasingly popular as concern for the environment grows.” Compared to flame-based cremation, aquamation uses 90 percent less energy, leaves one-tenth the carbon footprint and does not produce fossil fuels, greenhouse gases or mercury.

Faith Banks and Faithful Pet Memorial offer nose prints of deceased pets, as well as teeth, fur, paw prints and bags of ashes.

From their respective locations, Hobbs and Van Noort have provided aftercare services for a variety of pets – dogs, cats, reptiles, rodents, fish, birds, even domesticated farm animals – some species of which are not accommodated at other companies. As part of their jobs, they see a lot of grieving families. “Clients have disclosed to me that the death of their pet has affected them emotionally more than the passing of an extended family member,” says Van Noort.

Banks has encountered similar expressions. “Many people,” she says, “will tell me their relationship with their pet is purer, far less complicated and much more fulfilling than with certain family members. For some, it is akin to losing a child.”

Faith Banks and Faithful Pet Memorial offer nose prints of deceased pets, as well as teeth, fur, paw prints and bags of ashes.

The pet-loss experience is nearly universal, says Van Noort, and most people “have a story to share.” And she is happy to listen. “I encourage them to tell me about their pet and show me photos. Even if I had not cared for their pet, they can call me anytime to have a chat. There is a staff member at a local veterinary clinic who will often call me on behalf of a client who is having difficulty processing their pet’s death or impending death. If I am able to help, I feel honoured to be of assistance.”

Van Noort also gets referrals from past clients and friends. Most times, she hears from them after the pets have already died, but more owners are pre-planning. “They know their pet is elderly or very ill,” she says, “and they want to know ahead of time what their options are.”

Faith Banks and Faithful Pet Memorial offer nose prints of deceased pets, as well as teeth, fur, paw prints and bags of ashes.

As with any type of aftercare service, each day at Pets at Peace is different. Van Noort offers numerous options: preparation for burial at a pet cemetery of their choice, where a marker can be erected; or individual or communal cremation. Pet parents can also request to have ashes returned in an urn or a less traditional product, such as a pewter keychain urn, or in ash-infused glass jewelry. Even if a family chooses communal cremation, they can still have a clay paw print created. Although she is careful not to make any suggestions, Van Noort says that these memorial items usually become treasured possessions.

Set to retire after 19 years, Hobbs is preparing to close Pets at Peace Toronto at the end of the month. Van Noort, who says she has also reached “retirement age,” has no plans to leave the business: “I can’t think of not doing one of the things that is so rewarding for me and important for pet families.”

Faith Banks and Faithful Pet Memorial offer nose prints of deceased pets, as well as teeth, fur, paw prints and bags of ashes.

The death of her 12-year-old German shepherd/husky mix Spud in 2021 confirmed her dedication to her work. “I provided Spud’s aftercare, grooming his paws, doing ink paw prints and preparing him for transportation to the crematorium,” says Van Noort, who also has a 14-year-old border collie, Rider. “I realized I hadn’t provided him with any different type of care than I would provide to the pets entrusted to me. I wouldn’t want any less for others as I would have for myself.”

Complete Article HERE!

Grief, like death, is still taboo for many of us. But is that starting to change?

There are often no words for what we endure. Yet after the pandemic, more people are trying to find a language of loss

By

Widow is an awful word. It conjures up such drab and lonely images; and besides, it defines a woman by what she has lost and what she no longer is. But at least there is a word for having lost your husband. For the other heart-stopping losses that come to many in midlife, and some even earlier – the death of your parents, or of a sibling, or a child, or perhaps a best friend – there isn’t even a word. Yet these are life stages in their own right too, and deserving of closer understanding. For some reason, which may or may not be connected to the raw and unpeeled state of our emotions after a pandemic, a small window now seems to be opening on to an underexplored world.

The writer Clover Stroud’s The Red of My Blood, a memoir about trying to make sense of the death of her 46-year-old sister, Nell, from cancer, was published recently to a chorus of recognition and relief from some bereaved readers. After the funeral and the flurry of condolence letters, and the awkwardness of people just not knowing what to stay, there is still the long haul ahead of reconstructing a good life without someone who used to be central to it. And that’s what this book is about. Clover is a working mother of five: she might be dazed with grief but there is still pasta to be cooked, school runs to be done. In the spaces in between, however, she is constantly puzzling over the seeming impossibility of Nell being gone. How can she simply stop existing? The book revolves around Clover’s constant search for her sister, looking for her in photographs and in places they went as children and in the last things she touched when she was still alive. When you lose someone you love, they are suddenly everywhere but nowhere. Decades on, I still remember that irrational lurch of recognition at the face in the crowd that surely has to be them – except, of course, when you get closer it isn’t, and can’t ever be again.

More pragmatic but no less quietly moving was the interview Harriet Harman gave last week to Sky News’s Beth Rigby about coming to terms with the loss of Jack Dromey, her husband of 47 years. They were one of the most devoted couples at Westminster, and Dromey’s unstinting support for his wife powered her through the most gruelling stages of her career, juggling small children with working in a parliament still deeply hostile to women. But intensely as she will have felt the loss, as she points out she might have decades left to live without him – and she is trying to figure out how widowhood can become a different chapter in life, not the end of it. “People say, ‘Oh now that you’re on your own …’ but – I’m not with Jack any more, but I’m not on my own. I’ve got my children; I’ve got my friends; I’ve got my work colleagues. And I don’t agree with the notion that’s somehow out there that when you’re a widow your life is over and that somehow you’re a lesser person,” she told Rigby.

For all the grief and loss, she said, “people are themselves in widowhood just as they are themselves in the rest of their life”. As women they are very different characters, but both Stroud and Harman are grappling with essentially the same thing: how to find life again in the midst of death, without pushing away or denying the reality of what has happened.

It’s a stage most of us would perhaps rather not think about, even though grief comes to almost everyone who loves someone in the end. But if death itself is the last taboo, then the final frontier to be breached is what comes after; the slow, difficult process of learning to live with that loss, which takes much longer than the impatient outside world is often willing to accept. Time heals, everyone says, and there is a sort of truth in that. The wound doesn’t go away but it does change, slowly solidifying into scar tissue that will always be there. The beauty of Clover’s book is that there is no neat ending, just as in death there so often isn’t. What’s left, however messy, is the search for a different way of living.

Complete Article HERE!

I kept reliving the moment my mother died.

Understanding the flashbacks helped me grieve – and move on

I spent two years watching cancer take my mum – and even longer trying to dull the memories. Now, I can finally remember the happier times

By

It would happen when I least expected it. At the checkout at the supermarket, or sitting in the park. Suddenly, I would find myself back in my parents’ flat, watching in horror as my mum took her last ragged breaths. Years later, I could still recall every detail and the feeling of her frail hand growing colder in mine. Each time, it was like reliving her death all over again.

Grief toppled me after my mum died of bile duct cancer in 2016. The chaotic jumble of emotions left me feeling numb and drained. I knew that shutting myself down and locking away my sadness deep inside me wasn’t the best way to cope, but I didn’t know what else to do.

I tried counselling, read grief message boards late into the night, attended support groups. They helped in small ways, but they did nothing to lighten the suffocating weight of my loss. Then, one day, I found myself in a community centre in King’s Cross, London, talking to a group of strangers.

I had signed up to a 10-week grief workshop, which was almost over. On the board was a crude drawing of a brain with lots of little cameras surrounding it. This is how flashbacks are produced when something traumatic is happening, explained Dr Erin Hope Thompson, a clinical psychologist and the founder of the Loss Foundation. Our brains try to record everything. That is why, when painful memories drift back, they remain so raw and vivid.

“The brain changes quite dramatically when we’re in a traumatic moment,” Thompson says now. “It goes back to fight or flight. The part of the brain that is trying to capture what happens – the limbic system – goes into overdrive. Blood flow increases to this area.” Like the camera in her metaphor, it starts taking lots of snapshots. “It’s trying to capture as much as possible to keep us safe, so that, if we were in the same situation again, we’d know what to do.”

Ann with her mum in Finsbury Park, north London, in 2014
Ann with her mum in Finsbury Park, north London, in 2014.

At the same time, the blood that flows to the part of the brain that stores these memories and puts a “time stamp” on them decreases, she says. “These traumatic memories haven’t been processed in the normal way. They’re kind of floating around. A flashback is our brain trying to process what happened.”

Most people know about the five stages of grief – denial, anger, bargaining, depression and acceptance – popularised by the psychiatrist Elisabeth Kübler-Ross, but there is much less talk about flashbacks and the role they play in helping us move through pain. They are most often described as a symptom of post-traumatic stress disorder.

But sitting there, listening to Thompson describe how the brain produces them, something clicked. Flashbacks are a common experience for many people who are grieving. A 2012 study found that 69% of people experienced them in the lead-up to the anniversary of the death of a loved one.

“We often retain those memories very strongly because they’ve got a lot of emotion around them,” says Andy Langford, a counsellor and the clinical director at the bereavement charity Cruse. “It’s not just an intellectual memory that we can think of and then dismiss. It’s something that’s really highly charged. They can involve any of the senses. They can be visual, but they can also involve smell, or hearing someone’s voice, or the sounds of when they died, like the rattle in the throat.”

While my head was stuck on the last moments of her life, I hardly ever dreamed of my mum. When I did, she always appeared as she looked in her final months – sick and emaciated, not healthy and happy, as I had known her for most of my life. Clearly, my subconscious was a mess. So I felt relieved to hear a logical explanation for my inability to get past that moment. It wasn’t just that my heart was hurting, but that my brain wouldn’t let me move on.

Before then, I had understood a lot of things about grief – that it would leave me shipwrecked in anguish and that I wouldn’t be the same again – but it was only when I learned about flashbacks that I acknowledged that what I had been through was truly traumatic. My mum was sick for two years – a long time for the aggressive type of cancer she had. Watching her waste away slowly was agonising. In the last few months of her life, we were twice told prematurely that she had only a few days left and to say our goodbyes. Each time, she struggled on and defied the doctors’ expectations. Eventually, her body just couldn’t do it any more.

Linda Fairweather, 58, attended the Loss Foundation workshop after her husband of 31 years, Keith, died of throat cancer. She was struggling to cope with the painful memories. “I felt like I was going a little bit mad, because I used to suddenly go to a place and couldn’t pull myself back,” she says. “With the flashbacks, you get the images, the smells, everything. I would have moments where I would just flash back to certain parts of it. I could be really happy and feel like myself. And it would just drag me back down again.”

Since she learned how flashbacks work, hers have dissipated, although they haven’t stopped entirely. “They really upset me,” she says. “But I feel like I’ve got the tools to deal with them. I know what’s happening and what to do with it. I know they’ll pass. I try to give myself time.”

If you are experiencing flashbacks after the death of a loved one and it gets too much for you, you don’t need to sign up to a grief workshop. Langford recommends talking to a friend or a counsellor, or observing rituals that you did together, such as going for a walk to their favourite spot. “Those things are really helpful, because they can act as a reminder of what was good with the individual’s life.”

For people who are really struggling, eye movement desensitisation and reprocessing (EMDR) is one of the treatments offered by the NHS. Langford says EMDR “can help stimulate the brain’s processing of the incident, which can then lessen how raw the emotions are”. It involves recalling the traumatic memory while a therapist directs you to move your eyes from side to side, or taps your hand.

On my way home after that workshop session, various difficult memories I hadn’t thought about for a long time suddenly resurfaced, as if my brain had been given permission to open the floodgates. I cried hard that night. But since then I have stopped being haunted by my mum’s final moments.

Not that grief ever ends. You learn to exist with it. There is a stone in your heart. Sometimes, it is big; it rubs and makes you bleed. Sometimes, it is small and you can almost forget it is there.

I still think about that time, but the power has been taken away. My memories are no longer as visceral; I can look back with a sense of detachment. Now, I can focus on remembering my mum as she really was – a wonderful and caring person with a sweet smile, who loved her children more than anything.

Complete Article HERE!

How I learned to talk about death and dying

First step: Acknowledge it, together

By Steven Petrow

A serious illness is many things — terrifying, painful, life-altering. The prospect of losing a loved one, or your own life, becomes an unspeakable agony. It’s also isolating in a way I never could have imagined. I’ve been the one in that sickbed, and I’ve also done some time sitting beside it. I wouldn’t wish either experience on anyone.

Lately, however, I’ve been thinking about what memoirist Meghan O’Rourke has called “the long goodbye” and trying to focus on the one gift it does give us: the gift of time. Time to plan, but mostly time to unearth and process our feelings. And then, if we’re fortunate, to be able to share these deep-seated fears with those we love.

This is not easy. When my mother learned she had lung cancer several years ago, we both turned to humor to help absorb the meaning of her diagnosis and to deflect the pain. One afternoon, many months before she died, Mom said with a wry smile, “I think I’m really dying.” To which I replied, “You mean today? Because I’m going to the market, so if you really think so, I won’t shop for you.” “That’s hilarious,” Mom countered, a hungry smile now on her face. “What’s for dinner?” Very adroitly, pretty much reflexively, we had avoided the elephant in the room.

Mom’s health deteriorated over the next several weeks. Again, she raised the question of her death, but now without the smile. “Will dying be painful?” she asked. In that moment, I knew I needed to confront my own feelings about her mortality and not sidestep the conversation with facile banter.

I took Mom’s hand in mine and said, “Don’t worry, it won’t be painful.” I told her hospice had provided a “comfort kit,” which contained medications for restlessness, confusion, anxiety, sleeplessness, constipation and, of course, pain management. I could feel Mom’s hand relax. Finally, she said, with a palpable sense of relief, “Thank you.”

In the weeks after that, we began a new chapter. I hadn’t realized how much effort had gone into my denial. I thought about the many times I had said, “if you die …,” which denied what we both knew was inevitable. After I dropped the subjunctive and began to talk about when she died, a barrier was eliminated. She knew. I knew. Now, we knew together.

I don’t think Mom suffered in her final days. After she became “unresponsive” (considered part of “active dying”) I returned to that comfort kit at the direction of a nurse. I removed the liquid morphine and gently squeezed one drop, then a second into her mouth. When the end came a few hours later, my sister, brother and I sat on her hospital bed, holding hands with each other and our mother as she died. What a gift, I thought, as we helped her to let go honestly, openly, and — most importantly — together.

Three decades earlier, when I was newly in remission from my own cancer, I had so many worries — about recurrence, additional treatments, more surgery. But at its core the fear was always about dying, which I never acknowledged, which meant no opening for others to broach the topic. I tried hard to keep those anxieties buried away, mostly by taking anti-anxiety medications. I’d pop a Klonopin and for four hours I’d be “fine,” as I often repeated. Still, I felt detached from others, even myself, but in my mind, that was better than feeling. Or worse: talking about feelings with others.

I chose to be alone.

Every time when I returned to the hospital for follow-up labs and scans, I’d medicate. But drugs, it turns out, can do only so much. I’d still taste the fear in my throat, or notice the shallowness of my breathing. A few times I vomited — spontaneously — the associations too strong. No matter how hard I tried, I could not effectively lock away that demon, that fear.

Then I decided to volunteer at the cancer hospital that had given me so much, sharing my cancer “experience” with patients, which invariably included discussions of fear. I realized how helpful these conversations — about hair and weight loss, recurrence and remission, life and death — were to the patients I met in the hospital, either newly diagnosed or undergoing treatment. But these talks changed me, too.

For far too long, my fears had been caged inside me, dense and dark. Laura Wallace, a licensed clinical social worker whose practice focuses on transitions and loss, explained that acknowledging feelings of “loss and longing,” while deeply painful, is a much better alternative than anger, addiction and anxiety. Or denial.

Releasing these fears — into the rooms where I had these conversations, into the air outside the hospital when I would walk away — was liberating. Imagine a vial filled with dark blue worry. Release a drop into a small cup of water and it colors the water. Release another drop, this one into a gallon bucket, and it becomes nearly impossible to detect. By acknowledging and sharing my fears openly, I let them go and they began to dissolve. Eventually, I stopped taking those anti-anxiety medications.

In her recent memoir, “Going There,” journalist Katie Couric, whose husband died of colon cancer in 1998 at age 42, tells of feeling trapped between a rock and a hard place. “I was so worried about letting go of hope because I didn’t want Jay to spend whatever time he had left just waiting to die,” she wrote. “I think it takes extraordinary courage to be able to face death, and I think I was too scared, honestly.”

Couric’s words reverberated with me, especially as I’ve tried to take the lessons learned from my mother’s death, and my own illness: How to be present. How to balance today with tomorrow. How to find the courage to embrace what’s so often unspeakable.

A longtime friend, Barry Owen, succeeded in all three ways.

At 66, he revealed his pancreatic cancer diagnosis in a blog post. He knew, as did his husband, Dan, the unforgiving prognosis. (Stage IV pancreatic cancer has a five-year survival rate of 1 percent, according to Johns Hopkins Medicine.) “I have no illusions about this disease,” Barry wrote on his Caring Bridge blog, which was read by about 30 of his closest friends, including his two brothers.

Three months after his diagnosis, Barry pushed open the door to a conversation about dying. “Dan and I are starting to talk about planning, planning for my death,” he wrote. “This is not easy to write about.”

It was not easy to read about, either. But we joined the conversation with Barry and Dan, I hope, supporting them if not sharing their pain.

Barry did well enough for a while — long enough to celebrate his 67th birthday, to make a farewell tour to friends, and to enjoy the winter holidays. By spring, all that had changed. Eleven months after diagnosis, one of his caregivers posted the sentence everyone expected, yet dreaded. “So, yes, he is dying.” We understood. Barry’s followers made that final journey together with him.

During those final days I thought of “The Mary Tyler Moore Show,” one of Barry’s favorites, specifically the final scene where Mary, Rhoda, Lou, Ted and all the rest huddle, and walk offstage together, as one. It’s a tear-jerker, for sure.

We leaned in, through the Caring Bridge site. One friend acknowledged the heartbreak of losing Barry. His brother, Jamie, posted: “We all know the inevitable result, but it doesn’t keep me from becoming emotional every day.” I wrote that I’d burst into tears upon reading the news, but that I felt so deeply connected to his friends. Amid all this, a friend reminded us that Barry’s mantra had always been “Only connect,” which to him spoke to the importance of our relationships to help defeat “the isolation” — as novelist E.M. Forster put it — that keeps us apart.

I felt privileged to be among all these beautiful souls, so in touch with their feelings and able to express them. I thought then — as I do now — how rare this gift is. When Barry died, we held onto one another, tightly albeit it virtually. One friend posted, “Although I only know a few of all the friends around Barry, I feel part of you and share your grief.” Another wrote, “How terrible our loss.”

Complete Article HERE!