Is There a Solution for Chronic Sorrow?

Kaethe Weingarten of the Department of Psychiatry at Harvard Medical School recently published a paper describing her experience with four clients who experienced chronic sorrow. The clients, who were all successful, vibrant women, had different pasts and different conditions that caused them to lose their sense of self. Despite these differences, the result was the same for each. They struggled with a sense of deep sadness or chronic sorrow. In one’s case, illness had caused her to lose her independence and ability to live the life she once knew. Another woman became addicted to medication that was prescribed to treat a health problem. The addiction led to psychosis that lasted two years. The third woman was born with a heart defect and has lived a life of longing to be the woman she knows she cannot be. The fourth woman was diagnosed with Chronic Fatigue Syndrome. After over a decade of being doubted by family members, medical professionals, and even therapists, this client eventually committed suicide.

Weingarten, having dealt with her own disability, is all too familiar with the shift from a life of autonomy and ability to one of utter dependence and incapacity. She believes her own experience and those of her clients gives her an insight into chronic sorrow and how to best approach this issue with patients. First, Weingarten believes that chronic sorrow is rooted in a loss of self. The self-narrative of those living with chronic sorrow becomes shattered, dissociative, and disrupted. This can happen as a result of one catastrophic event, such as a debilitating medical diagnosis, or a series or progression of events and symptoms, as was the case for the client with Chronic Fatigue Syndrome. Regardless of how it occurs, this broken narrative is not one that can be fixed. Instead, Weingarten believes that companionship and compassionate witnessing are the keys to living with, and not necessarily overcoming, chronic sorrow.

She believes that witnessing requires developing an empathic understanding of a client’s situation and taking actions to alleviate the psychological pain that ensues. Rather than trying to fully understand, a compassionate witness should accept that they will never fully be able to feel the feelings or loss of their client. Instead of pathologizing and labeling these clients’ reactions to loss of self as bipolar, schizophrenic, or psychotic, a truly compassionate witness will empathize without ever really understanding. “People who live with chronic sorrow need accompaniment,” said Weingarten. By this, she means that clients with chronic sorrow need someone to be with them as they discover how they will interact with the limitations of their minds and bodies. It means showing them the way to peace, teaching them how to tolerate the inconsistency of their lives with support, education, and even humor. It also means requires self-care so that the therapist can be aware of the client’s own boundaries while they take this journey with their client. Weingarten does not believe chronic sorrow can be fixed or healed. But she believes it can be lived with and she suggests compassionate witnessing and companionship as ways to do that.

Reference:
Weingarten, Kaethe. Sorrow: A therapist’s reflection on the inevitable and the unknowable. Family Process 51.4 (2012): 440-55. Print.

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  • marissa

    January 8th, 2013 at 9:04 PM

    having been depressed twice in the past,I can understand some of this.maybe chronic sorrow is different from being depressed,but trust me,it is not easy whatsoever!

    trying to act like you understand everything is not going to help,that’s true.if anything,just show that you are there as someone to turn towards,and a shoulder to support.often depression and sorrow can make a person feel worthless and even detached from the self.it is very important to try and show the person how he or she is good at something or to appreciate him or her for something nice that they did.

  • Carlisle

    January 8th, 2013 at 11:18 PM

    Some people are just more prone to being sorrowful.While everybody experiences grief and sorrow from time to time,I think some people have a harder time trying to get over it.Getting out of that phase may prove to be tougher for them.If they are able to gain some support from bear ones In such a situation it can prove to be really helpful.

    I don’t know much about the exact kind of support to provide,I’m no expert here,but support is always nice and welcome.A helping hand is always a delightful thing to have in times of despair.

  • Meredith

    January 9th, 2013 at 11:17 AM

    I’m sorry maybe I missed this, but what is the difference between this and being clinically depressed?

  • Ted

    January 10th, 2013 at 4:05 AM

    I am so happy to finally read somewhere that a diagnosis is not always a true understanding!
    Just because you have a label to put on something does not answer all the questions nor does it always offer a solution.
    Sure, it could point you in a right direction to acquire healing, but in no way does it or should it marginalize what the patient is going through.

  • Nicole

    January 10th, 2013 at 11:16 AM

    Well I don’t want to blame those people that already have a tough time with sorrow…But I think sorrow is just one of those things that requires a bi of an effort to go beyond…And some people are just not ready or willing to put in that effort.Sure its not like they want sorrow to engulf them but they could always do more to protect themselves from its effects…!

  • Linda

    January 27th, 2013 at 9:59 PM

    In my view, chronic sorrow is not the same thing as situational or chronic depression; I have experience with all three. As Weingarten describes it, chronic sorrow can, for some people, be the result of a profound loss in one’s life, or series of events, losses or assaults on our sense of self, our personal narrative. (In my case, the sudden and accidental death of my young-adult child, followed within two months by serious surgery, and the simultaneous, unexpected loss of a long-help position.) It is my experience that the goal of learning how to ‘live with’ this, or with any devastating change in what one expected or desired out of one’s life, due to circumstances that cannot be controlled, is an appropriate goal, a far more realistic and attainable goal than ‘healing’ or ‘recovery’. I will never be healed from my son’s death, I will never recover… To learn to accept the break in my story of self, my personal narrative, to accept that I may never regain a sense of self in the way that I wish for, and to have compassionate witness and support while on this journey, to hope to reach a day where there is some small sense of peace, of balance, would be a good thing. I appreciate Weingarten’s honest assessment, and her encouragement of empathic companionship and support for those whose spirits, whose psyches, have suffered such devastation.

  • Lisa

    April 25th, 2013 at 12:55 PM

    I’m a very strong person. I have overcome many disappointments and Depression. Having to change my lifestyle due to a non curable Leukemia is not what I had planed on for my life. Yes we learn to deal with the illness and cope through the challenges. The sorrow and sadness slowly seeps in dealing with my personal loss. To grieve for the loss of health is overwhelming.To deal with disappointing news constantly the sorrow continues. When everyone is out partying during the holidays I was home alone sick. I have to stay away from crowds. People slowly stop coming by. Your life becomes filled with Doctor appointments constant lab reports and treatments. Sorrow and stoicism can live side by side. To make matters worse my Adult child is going through a difficult time and decided for what reason I don’t know to abandon me. I have tried everything I could do on my end to open up dialogue. He refuses to meet me half way.This also means I don’t get to see my Grand Daughters. Life goes on the sorrow continues but my hope for a cure or remission for cancer continues. Sorrow is in a league all of its own.

  • Susan Roos

    July 9th, 2013 at 9:24 AM

    I stumbled on your article and wanted to tell you that your contribution to reognizing, understanding, and coping with chronic sorrow is deeply appreciated. It adds to the sparse literature base in a meaningful and authentic way. I hope you are well!
    Susan

  • Rebecca

    July 5th, 2014 at 2:49 PM

    Chronic sorrow is not that way. It is an ongoing, living loss–or more accurately, a series of losses with constant triggers. Most of us can grieve one loss and move on, but with disabilities/inabilities, the losses and reminders can be daily.

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