lisa-snyder-share-your-story-0305138I woke up to my dad staring blankly at the wall the morning of October 14, 2004. It was the day before my 23rd birthday. I knew this day was coming, but nothing would prepare me to wake up and find my dad no longer alive—just a lifeless shell. He had battled Hodgkin’s lymphoma for a year and a half. At 54, his time here was over.

After my mom and I had cried over his body and walked the body bag down the hall, we decided to go out for lunch. Such an odd next step after your father was here on earth and now is suddenly just … not. We ate steak and potatoes and drank Diet Coke in his honor. It’s these things, I’m pretty sure, that led him down the cancer path, but that’s another story.

When I got home from lunch, I was all alone in the apartment we had lived in together. Strange things started happening. The lights went on and off. The song “Time Is Ticking Out” by The Cranberries was stuck on repeat on my stereo, the caps and num locks on my keyboard blinked back and forth without me touching anything at all, and my quiet cat, Bastian, was staring up at the corner, meowing at the wall. I was sure this was my dad trying to communicate that he had crossed over.

When I looked at him earlier that day and had called out, “Dad?” as if he was going to respond to me … I knew he wasn’t there, but what an odd thing? How can you be there and then … just not be there anymore? This moment made me come to be obsessed with learning about near-death experiences and worlds beyond the physical.

As I attempted to maneuver life, I felt like everyone started to disappear. The relationships my dad had built slowly started to fade. People were as scared to see or talk to me as I was of them, fearful of dealing with the harsh realities that my father was no longer with us. This took such a toll on my heart, as I wanted so badly to connect but had no idea how. How could life have brought me to this place of being 23 and not able to enjoy my dad in my life? Why do other people get this opportunity, yet it was “stolen” from me?

The Real Truth About Death
I continued to explore spirituality, reading many books about near-death experiences. P.M.H. Atwater changed my life with her book, The Real Truth About Death. In this book, Atwater tells the story of physically dying three times, each time going deeper into the afterlife. After returning from the dead, she interviewed more than 3,000 people from around the world who also had near-death experiences. After reading this book, I fully believed there was life after death. How could there not be? So many people from all over the world telling similar stories of tunnels, light, loved ones who had passed greeting them, and many times someone telling them their time is not over and it’s time to go back … doctors who can verify that their heart stopped beating for long periods and they were thought to be totally dead … there are too many similarities from all walks of life, all religions and ages, not to believe.

One evening in September 2008, I had one of the most dramatic spiritual experiences of my existence. I remember this event very clearly because I was conscious for all of it. My father came to me as what I can only describe as a spiritual entity—a ball of energy and white light. I knew it was him because I could feel him. The last time I had felt him in that way, he was alive and here on earth. He told me, “You need to spend more time with your mom because you don’ t know how much longer she’s going to be here.” I took this information very seriously and decided to take the opportunity to have a big 27th birthday party and invite my mom.

The Red Party
In October 2008, I had a red-themed party. Everyone came dressed in their brightest red. It was so good to see my mom, as we were just beginning to become friends again after a long period of post-teenage-into-early-twenties angst and her not fully accepting me dating women (I’d like to note that on my dad’s deathbed, he asked my mom to please accept me for who I am. Without the acceptance, we probably would not have a relationship in life.) This would be the last birthday she would spend with me.

A few days later, I learned that my uncle had taken my mom to the hospital. She was feeling weak and wanted to get checked out. I had planned to meet some new web clients at a cafe on this particular day. I’ll never forget waiting for my clients to arrive and, in the meantime, getting the phone call from my mom. She never expressed too much sadness in my life, but on the other end of the line, she was crying. “Lisa, I have leukemia,” she said. My heart dropped into my stomach. I realized this could be the very moment my father tried to warn me about.

We started the cancer roller-coaster ride of deciding what chemo to get and hospital visits. A few months in, the doctors had told us she was officially in remission. Come to think of it, this may have been a lie my mom had told everyone so we wouldn’t worry. In April 2009, her doctors had a sit-down with us and had the dreaded “there’s nothing else we can do for you” conversation. “All of your inner organs have a tumor wrapped around them.” ARE YOU SERIOUS? Part of me thought it was all a joke, and the other part of me was like, OK … OK universe … I know what’s going to happen. You have prepared me for this once before, and I’m going to have to do this again.

“I’m Sorry You Won’t Have Parents”
Later that day, I sat at my mother’s feet as she placed herself in the Pepto Bismol-colored recliner I had slept in many a night. She said, “I’m sorry you’re not going to have any parents anymore.” (This sentence has echoed in my brain thousands of times since this moment.) We used our time wisely, attempting to get things in order (or at least as in order as my mother would let them be). We watched our favorite movies, like “The Golden Child,” and laughed and cried in each other’s arms. I told her how much I was going to miss her … how much she meant to me, how thankful I was for her having me and everything she did for me in her life. She confided in me about things she would have never told a soul if she had the opportunity to continue on. We giggled at night about farts and stinky feet. I stopped my life to spend as much time with her as I could. I knew this time was precious and measured by the universe. I wasn’t going to let one drop of it go.

I was with her during her last weeks on earth. As the day got closer, she began to see people. My dad and her mother had come to tell her it was soon time. She had also seen people in Bermuda shirts with red balloons getting ready to welcome her. She saw an angel and I asked her to describe her to me. Long, blonde hair, white light around her, beautiful white dress … I could tell my mom was readying herself to transition, and these greetings were comforting to her. I played Enya in the background. Got her a professional, cancer-trained masseuse. Asked friends to join us and play music. The dreaded coma before death finally began to set in, and I wasn’t sure what moment she was going to go; it seemed like every breath could be her last.

Before I left to get some sleep, my mom had woken up with that last energy thrust many speak about (my dad had done the same). She was thirsty and hadn’t had water in what felt like days. I had been wearing a special shirt just for my mom because she liked it. The last thing she ever said to me—and I have no idea how she could have even formed words, because she had been on the edge of death for so long—was, “That’s a pretty shirt.” Hours before she passed, I began to get blank emails sent from no one, with nowhere to reply to and no subject line. Friends came to spend last moments with her. Her body got cold, her temperature was no longer reading on a thermometer … and after midnight on June 23, 2009, I watched my mom take one last, long breath. I had been watching the heartbeat through her neck for hours; after the long sigh that came from her lips, there was no movement at all. She seemed to settle into a peaceful smile. Her brow had calmed … her last day on earth had finally come … and I realized all at once that I was actually, totally, and utterly alone.

I sat with her for a little while, until a crew of people came barreling in to “place” her body so that when rigor mortis set in, she wasn’t in a weird position. They told my uncle and me that we had about an hour and then had to leave, so we gathered up her things and walked out to the parking lot—which may have been even more weird than when I went out to lunch and then went home after my dad died. I told my uncle I loved him, went into my tired, blue jalopy, and cried harder than I had ever cried in my life. I wailed as the idea of being alone in the world sunk in … that I knew this day would come … but I was only 27 and would now have to live out the rest of my days attempting to make sense of being so young and without parents.

The days that followed were the most difficult in my life. Freshly moved by two beloved friends (I will never forget what you did for me) the day after my mom’s funeral, one by one everyone I knew went back to their regularly scheduled lives and I was left in an empty apartment, with no parents and way too much alone time.

A Turning Point
During my mom’s illness, I had started to paint whenever I came home from visiting her or when I felt sadness. Although I had gone to art school, I had never really done much work with the canvas. It gave me peace to move  paint around with a brush … my fingers … a random object. It was something I felt was beautiful, that I could control, and that helped me express feelings that continued to bottle up. This was the creative outlet I needed.

For several years, friends had asked me to submit to a local community art show. I felt finally this was the year I was going to submit. I found this painting I had worked on during my mom’s illness and decided to submit it to the show, completely releasing whether it would get bought and just focusing on the satisfaction of the simple act of submitting to a public show I’d always wanted to participate in.

I submitted it very last minute and the piece was placed in what I thought was a semi-punishing, badly lit area of the show. We spent hours at the show and, prior to our departure, my girlfriend and I stopped by for one more look—and there it was: a red dot! The piece had been sold!

Submitting this piece was a complete turning point for me. I learned that I had created a healing method that was between me and me. I could work through feelings by placing energy on the canvas, and suddenly I felt like negative energies such as fear and anxiety were being channeled and released on these canvases. The healing process had truly begun.

In April 2011, I decided I wanted to explore blogging. As a web designer, putting one together was easy, but what kind of writer was I? There was only one way to find out! I told myself that I would write when I felt pain and try to turn it into something positive, creating what has become a recipe book for myself and future life situations. My intention was to connect those who were suffering from parental loss, like I was, and to hopefully help myself and others heal through art, writing, and focusing on the positive. Thus, LosingYourParents.org was born.

My intention is to enjoy the time I have in this life, and if I’m not enjoying it, to figure out what I need to do to get unstuck. I got a tattoo that says “follow your bliss” to always remind me of this thing that can seem so easy to forget.

Using my blog and art has helped me tremendously through the healing process. Those of us who have lost our parents are forever changed and will never forget. I do have faith that if you’re dedicated to wanting to live a brighter, lighter life, doing the work, finding the tools, and feeling the feelings will help you move forward. It has helped me. You’ve got to feel to heal.

negative-self-beliefs-0227135Are you a “beaten dog”? Rest assured, I’m not calling anyone names here. But have you been kicked around, treated like nothing, and hurt? Do you not feel loved unless you are treated badly? This is what I mean when I say “beaten dog.” If you are offended, maybe some truth is staring you in the face. If you are not offended, I’m glad—and while this may not apply to you, perhaps it does apply to someone you know.

If it does apply to you and you can see how this role has affected your life, I want to apologize. No one should feel beaten, abused, and treated so poorly that he or she feels unworthy and believes life is cruel. I hope you seek help in breaking this mind-set and take hold of the reality that you ARE worthy!

Some questions you can ask yourself:

  1. When someone is nice to me, do I question it? Do I question that the niceness is sincere?
  2. When things are calm and smooth, do I need to throw a fit so that I can verify that I am loved via being yelled at?
  3. Do I want or tend to take advantage of a person’s niceness because I believe I can?
  4. Do I pick negative, hurtful people to be around?
  5. Am I envious of others who are in healthy relationships?
  6. Do I want a healthier relationship but believe I can’t have one?
  7. Do I believe that this is how things will be for the rest of my life and that nothing—not even me—can change?

To change a self-belief statement or self-perception, admitting the need to change is a must. If you change for someone else, the change may not last long. Identifying how you respond to the above questions is key. Looking at ourselves can be a difficult and painful challenge, but it is where healing begins.

A self-belief statement can be defined as how you view who you are, how your “world” is, and how things (positive or negative) happen/happened to you. When someone is brought up in a negative, abusive, and painful environment, a negative self-belief is formed. The self-belief statement can be changed, but it can be difficult and takes time.

To change a negative self-belief statement:

  1. Identify and be aware of your negative self-belief statement. As Dr. Phil says, you can’t change what you don’t acknowledge.
  2. Self-examine your thoughts and mind-set, and take responsibility for why your belief statement is negative.
  3. Acknowledge what you can and can’t change. Example: You can’t change what happened to you growing up, but you can change how you respond and whether the past controls you.
  4. Grieve. You lost out on a healthier childhood, the unspoken expectation that the adults in your life would be there to help you grow. Let go of the pain. Mourn. Cry.
  5. Forgive. It’s a hard thing to do. Forgiveness is for YOU, not for them. To lose the power that the past has over you, forgiveness is key. Forgive shortcomings, failures, pain, whatever. Let go. Forgive yourself for not being perfect. When you forgive, you’ll feel less weight on your shoulders and be able to move on a little easier. Forgiveness is a part of a cleansing process, allowing healing to begin.
  6. Redefine yourself—who you want to be, how you want to be, the type of people you want to be around, etc. Your personality may not totally change, but you can choose to be happier, to not let the same roadblocks stand in your way, and to have healthier relationships. You can choose to be a person who is not going to allow yourself to be kicked around anymore. Find what is good in your life; maximize those things while minimizing your weaknesses.
  7. Be at peace with yourself. Self-acceptance is a great accomplishment. No one can do this for you. When you love and accept you, other people will see that and be drawn to it. Self-acceptance allows your inner beauty to shine.

This is a process. It’s not always easy. Personal growth is not a straight journey. It has lumps, bumps, breaks, and is topsy-turvy. But if you are moving toward health, you will get there.

139610717It is not unusual for someone who experiences a loss to romanticize the person, identity, or object they are grieving. This can occur even when what is lost was not just imperfect, but harmful. This tendency occurs more often and can be more harmful with folks who experienced depression, anxiety, or other mental health issues prior to the loss.

Myths can be helpful in meeting the obligation of respect and mourning we may feel toward the person. They can push us to broaden our memory of the person who died or the relationship we had beyond just the negative event to more positive or helpful content. They can influence the “story” of what was lost in a way that makes thoughts and emotions associated with the loss more tolerable to access and communicate individually and within our support systems.

It is natural to go back in time and reevaluate our perceptions of events and the decisions made during that time. Those who struggle with depression or anxiety already have a distorted view of reality that usually presents a world that’s unsafe or themselves as incapable. Both of these factors can set the stage for harmful myths.

Beliefs that drive guilt, regret, and failure are usually present and, when applied to the loss of a relationship, can set the stage for a rewrite on reality. These factors can result in a person deriving a meaning or value from what was lost that is heightened and, in his or her mind, exposes an inability and unworthiness in obtaining and holding onto the things people deserve to pursue. Even if the person holds some, or the majority of, responsibility in the loss, what was lost was probably imperfect and the behaviors that led to the loss are changeable. We’re human, and life is usually a trial-and-error thing.

Myths can also amplify the lack of purpose one feels after losing a job, becoming hospitalized, or losing a relationship. This is particularly true if the loss involved something the person felt defined them: “This is who I was, and now that it’s gone, where does that leave me?” Myths can hold us to the belief that purpose is unchangeable and who we were before the loss was the best we could have been.

In reality, there may have been significant problems and costs to the identity that we were not attentive to; these costs may have been a factor in causing the loss. Myths hold us back from an honest analysis of what led us to “the problem,” which in turn, prevents us from changing our behaviors or priorities in a way that works for us now. Myths can make us risk-averse, because if it can’t be the same, what’s the point? The answer is that “it” being different may be what we need, and the loss could be used as a wake-up call. In holding onto myths, we may reenact patterns and behaviors that are maladaptive.

When the loss involves a person who was both a family member and a perpetrator, myths can act as an obstacle to accessing traumatic content. Survivors of childhood abuse utilize several strategies to survive their environments and maintain a positive view of those they love because of the meaning that relationship may have in their minds (“she is my mother; I’m supposed to love her”). From their perspective, pushing for change may have a greater cost than living with it. This capacity or inclination can prevent survivors from feeling as if they have permission to think about the person they lost in a negative light. These are common issues for any trauma survivor, but holding on to the myth after a loss may make the work in acknowledging and processing the trauma that much harder.

Within a familial context, myths can create a perceived demand for adherence to a “story” that may feel objectionable to some within the family. Trauma survivors can feel uncomfortable in processing the loss authentically with those they may feel closest to for fear of making waves or hurting them.

Grounding ourselves in fact can go a long way in helping us cope with a loss. Being factual means focusing on what we know, not what we believe, so that we can derive a reasonable meaning from the loss experience. It allows us to acknowledge and mourn the good while identifying what was harmful so that the work of adaptive grieving and behavior change can move forward.

One important aspect of remaining factual is communicating the emotional and cognitive content we hold to another person we trust. This allows us to expose any distorted beliefs or thinking to another person’s logic and perception. This is important because it creates an external brace against unreasonable thinking. By not allowing exposure, the only thing left to challenge the distorted narrative is the source of it.

Family, friends, and other natural supports (priests, rabbis, the lady who does your nails) are usually the best options if safety is not an issue because they represent long-term, sustainable resources you can access anytime. If safety is an issue or you are experiencing symptoms that go beyond a normal grief reaction, seeking professional help (therapists, psychiatrists, medical doctor) can provide more intensive support and a greater assurance of confidentiality.

151528446Imagine losing someone very close to you; perhaps your partner dies. How might you feel and behave in the weeks following this death? You might feel a sense of sadness and emptiness so intense that it is difficult to hold back tears. Perhaps you would have little interest in activities that you usually enjoy. Maybe you would find it difficult to sleep after sharing a bed with your partner for so many years. You might begin eating more or less and either gain or lose a significant amount of weight. It might be difficult to concentrate on your work. You might be preoccupied with a sense of guilt, wondering whether you could have done something to prevent your partner’s death. You might even wish for the day that you and your partner are reunited in death.

[fat_widget_right]

These kinds of feelings and behaviors, while certainly difficult, probably seem like pretty normal and appropriate responses to a significant loss. They certainly don’t seem indicative of a diagnosable mental illness, right? Well, until the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is released in May, your hunch is correct. Currently, these feelings and behaviors aren’t considered evidence of mental illness.

In order to meet the diagnostic criteria for major depressive disorder (MDD), five out of nine specific symptoms must be exhibited, more often than not, for two weeks or longer, and they must impair your ability to function. The example above actually includes seven of the nine symptoms of MDD. These symptoms would probably be present much of the day for several weeks and would certainly impair normal functioning.

Currently, however, there is an exemption for bereavement in the diagnostic criteria that allows for such symptoms to persist for up to two months after the death of a loved one. Only after two months of persistent and pervasive depressive symptoms can a diagnosis of MDD be made in the context of bereavement. This exemption acknowledges that while grieving can look and feel virtually identical to depression, it is, quite simply, not depression. Unfortunately, the new version of the DSM will remove the bereavement exemption from the diagnostic criteria, and come May, the very appropriate reaction to the death of a loved one described above will be pathologized and diagnosed as MDD.

The world looks to the field of psychology to understand normal versus abnormal behavior, and the field of psychology uses the DSM as its guide for drawing the often fine line between what is normal and abnormal. This is a responsibility that should not be taken lightly. Labeling someone as mentally ill has significant implications. In the best case, a person who receives a diagnosis is given a lens through which to better understand himself or herself. It can be deeply empowering for someone to understand that the thoughts, feelings, and behaviors that have plagued him or her have a name, and that there are not only treatment options, but hope­ as well—hope for healing, hope for growth, and hope to become the person he or she has always wanted to be.

However, in cases where a perfectly healthy person is labeled as mentally ill, the implications can be devastating—just ask the gay man who was considered mentally ill in the early 1970s before homosexuality was removed from the DSM. To be labeled as sick, to be pathologized, for being who you are, or for being appropriately devastated by the loss of a loved one, serves no purpose and may be quite harmful.

Imagine being told that the anguish you are feeling over the loss of your partner means that you are mentally ill. Is there any way that this could be helpful, or would it just serve to make you feel much more lost and hopeless? What would it be like if a doctor suggested you take medication? Imagine being told to take a pill to get over the death of a loved one. Should you find yourself in a therapist’s office grieving the loss of a loved one and your therapist suggests a diagnosis of MDD, don’t be so quick to accept the label—it is entirely possible that you are simply, and appropriately, grieving.

Man unpacking moving box full of Buddhist itemsAnyone who has been through a divorce knows very well that it can invoke the worst parts of the self. Divorce is consistently associated with contention, negativity, bad behavior, and a sense of loss of integrity. This is completely understandable, since the experience of divorce so often invokes feelings of fear, shame, anger, and resentment. When a marriage ends, these dreaded emotional states uncontrollably surface without warning or even awareness. Learning to manage these intolerable states of being is a crucial aspect of transitioning through divorce with integrity and an intact sense of self.

Since divorce generates such an intense state of suffering, it seems logical to turn to the teachings of the Buddha to help turn this painful life transition into an opportunity for learning and growth. Coincidentally, the Buddha’s wisdom and the teachings of Buddhism stem from the young prince Siddhartha’s disillusionment when the reality of the pain and suffering in the world shattered the perfect world image his father had tried to impart on him. Not too different from the illusion we create for ourselves with the ever-after dreams of marriage and the harsh reality that comes with divorce.

“Buddhist teachings are not a religion, they are a science of the mind.” —The Dalai Lama

Here are six Buddhist teachings that can help you remain open, and reduce your suffering, as you manage the transition of divorce:

Attachments
When divorce strikes, the past, present, and future are all up for grabs. Everything you thought you knew to be true is now in question. In the face of ambiguity and uncertainty, your instinct will be to grasp at what you know and once had, but according to the Buddha these attachments create suffering. Learning to release your attachments to any particular outcomes in the past, present, or future will lead to a more peaceful existence. Trying to control things only invokes feelings of frustration because most of the things you are dealing with are completely out of your control. When you grasp and cling to what you think you “know,” you are creating unnecessary suffering.

Compassion
The Buddha recognizes that while it might be relatively easy to generate compassion for friends and loved ones, it is extremely difficult to have compassion for someone we dislike or who has mistreated us in some way. While the tendency might be to avoid this person (most likely an ex), the Buddha would see this person as the heart of his spiritual practice, a challenge to develop positive qualities. Compassion is the flip side of anger; it keeps the heart open when it wants to close off with fear. Compassion is fostered by remaining connected, no matter how painful it may be. Maintaining compassion through divorce is a feat, but it will ensure that your loving nature remains intact.

Karma
The law of karma is the universal principle of actions and reactions or causes and effects. Everything you do or say in your daily life is the cause of your own suffering or your own happiness. Buddha would advise that you not look for answers outside of yourself, nor should you believe that you are a victim of a random universe. While you may feel like a victim of your divorce, karma is your key to taking responsibility for what comes in and out of your world. The word karma means “action” or “deed”—actions and deeds that impact only you and the space you inhabit on this earth. Once you take responsibility for your actions, you can actively change your karma, and ultimately your present and future circumstances.

“Pain is inevitable in life, but suffering is optional.” —The Buddha

Mindfulness
Mindfulness is the capacity to remain in the present moment. It is the ability to pay attention and to become aware of the intention behind what we do. The Buddha would recommend that you utilize the clarity that mindfulness brings to stop clinging to the past and the future, to live presently in the here and now. When we are not mindful, we remain in a state of being that is encumbered with criticism, judgment, and a need to be right. Mindfulness and its nonjudging, respectful awareness can help you to respond and to gain perspective, balance, and freedom. Stepping back and being an observer of events provides the greatest opportunity for acting with complete integrity and honor.

Aversion
One of the most fundamental teachings of the Buddha is that pain is an unavoidable part of the natural world, and suffering is our reaction to the inevitable pain of life. Divorce is one of those unavoidably painful life experiences, but as the Buddha would attest, it doesn’t have to involve suffering. Like touching a hot stove, our first reaction to pain is to move away. Our aversion to the pain creates more suffering and reduces the opportunity to heal. Suffering is directly related to resisting the reality of what you are dealing with. Instead, the Buddha would suggest doing what you can to restore balance, to let things take their course. Complete avoidance will only prolong the pain.

Impermanence
In Buddhism, impermanence is referred to as Anicca— the truth of impermanence. It is the belief that all of our experiences are constantly changing, and that nothing is permanent. One of the greatest causes of pain during divorce is the feeling that things will never be the same, and that what you feel now will last forever. The Buddha would apply the wisdom of Anicca to maintain a sense of calm and perspective through the grief and loss of divorce. Remembering that nothing in life is permanent will help you to not feel bogged down or to lose yourself in what feels like an eternal experience of pain and discomfort.

GoodTherapyorg-Grief-and-Loss-BlogsGrief has many causes and can manifest in many ways. Whether it’s triggered by divorce or separation, illness, trauma, or death, grief is a normal part of human experience. However, coping with grief can be extremely challenging; if grief is intractable, the support of a mental health professional may be needed. In fact, the upcoming fifth release of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), used by mental health practitioners to diagnose and treat a wide range of issues, does more to acknowledge the link between bereavement and depression than any DSM before it.

[fat_widget_grief_right]

Acknowledgment of the profound effects of grief and loss isn’t enough, of course. More must be done to point grieving people toward resources that can help them cope and heal. According to the National Institute for Mental Health, only 10% of grieving people will ever seek professional help.

While GoodTherapy.org is at its core a directory of therapists committed to treating issues such as grief and loss, it is also a comprehensive resource for people seeking mental health treatment and information. It is with that in mind that we selected the 10 best resources on the Internet in 2012—GoodTherapy.org excluded—for people experiencing grief and loss. Among the criteria we used to select our top 10 websites are quality and depth of content, presentation, and functionality.

We welcome your submissions for consideration in our Top 10 lists. Click here to nominate a site.

Lit holiday candleNicole is 16, and Ethan is 14. Their father, Jack, has battled brain cancer for the past two years. Jack was told recently that further treatment had a less than 10% chance of being successful. Jack wants to enjoy whatever time he has left feeling good and not being wiped out by chemotherapy. While no one wants to say it out loud, it’s clear that this will be Jack’s last Christmas (please substitute Hanukkah, Kwanzaa, etc., as appropriate).

How is Jack’s family supposed to come to terms with this? It can’t possibly be true. After the shock and complete denial subside, the painful reality begins to sink in. A flood of emotions comes with this realization, with profound sadness and anger often topping the list. It’s harder to face if your loved one is young and he or she has young children. The holidays speak of possibilities and are supposed to be a magical time for children; belief is suspended, and all holiday stories have happy endings.

The first step in dealing with this situation is to acknowledge that this will be someone’s last Christmas. Just saying that out loud will address the elephant in the room and help to decrease the stress that family members have been carrying internally. There will be tears, to be sure, but then the family can begin the process of grieving this sad reality together, rather than each member trying to deal with it alone. It is often the case that people don’t share their feelings with each other because they don’t want to be a burden, or want to protect the other person. In reality, family members are usually feeling at least some of the same things: fear, sadness, anger, and disbelief, to name a few.

After getting the topic out in the open, it’s time to think about how you want to celebrate this year. Don’t hold on to traditions if they don’t feel right. If you usually decorate your house to the rafters and host a cocktail party and an open house, it’s perfectly fine to do only some, or none, of those things this year. Every year, we all search for ways to make the holidays less commercialized and more significant. This year, it is especially important to ask yourself what makes the holidays meaningful for your family and your loved one. It may be as simple as sitting on the couch with a cup of eggnog and looking at the lights on the tree. Watching Christmas movies.  Listening to Christmas music. Going to a lights display. If your loved one is too ill to go out, he or she may still enjoy the experience by seeing photos of what others have done.

The person who is ill can give the gift of memories to those he or she will be leaving behind by writing letters or creating videos. If you are a parent, your children will one day be interested in what your life was like when you were young/their age. What words of wisdom do you have for them when they get their first boyfriend/girlfriend? Graduate from high school? Get their first job? Get married? Have a child? For some people, it is too daunting to consider making videos/writing letters; it puts them face to face with their own mortality too directly. In that situation, I suggest trying to think about it from your child’s point of view, not your own. The reality is that all of us will die, but not all of us will have the opportunity to choose how we spend the time we have left.

“It is not the magnitude of our actions but the amount of love that is put into them that matters.” —Mother Teresa

Girl leaning on fenceThe American Psychiatric Association has approved changes to the Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as the DSM. The fifth edition of the flagship guide to psychiatric diagnosis, due for release in May 2013 and known as the DSM-5, features several controversial revisions.

The DSM establishes criteria for the diagnosis of mental health conditions. Because changes to the manual can affect insurance coverage for certain issues and help define “normal” behavior, advocacy groups are often concerned about the effect additions and alterations will have. The latest revision is no exception.

[fat_widget_right]

Children and Mental Health
Diagnosing children with mental health conditions is often dicey because of concerns about stigma and the use, or overuse, of psychiatric drugs. At a time when some groups argue that fewer children should be diagnosed with mental health issues, the DSM-5 adds new diagnostic criteria for children. Those over the age of 6 who display irritability or frequent angry outbursts now qualify for a diagnosis of disruptive mood dysregulation disorder. While some mental health professionals emphasize that this new diagnosis could make it easier to plan early intervention for children who have extreme difficulties controlling their emotions, some advocacy groups have expressed concern that such a diagnosis could stigmatize normal childhood behavior or lead to the prescribing of unnecessary drugs to young children.

Autism Spectrum Disorder
The DSM-5 eliminates Asperger’s syndrome, folding it into a broader category called autism spectrum disorder. Diagnoses of Asperger’s and autism have been steadily increasing over the past several years, and many children with less severe symptoms of autism have been diagnosed with Asperger’s. The DSM-5, however, incorporates several autism-like issues, including Asperger’s, into the diagnosis of autism spectrum disorder. Not everyone is happy with this change. Many people with Asperger’s view the issue as part of their identity and do not want it to be lumped in with other issues. The APA, however, argues that this change will make diagnosis of autism more consistent and access to treatment easier.

Grief and Depression
Previous versions of the DSM incorporated a bereavement exception into depression diagnoses. This exclusion prevented mental health professionals from diagnosing a person who was grieving the death of a loved one with depression. The DSM-5, however, permits depression diagnoses in the bereaved. Members of the APA argued that the old bereavement exception excluded grieving people who had been diagnosed with chronic depression from being diagnosed with, and receiving treatment for, depression. But some people worry that the new changes pathologize grief and turn normal grieving—which often looks a lot like depression—into a mental health diagnosis.

Other Changes
The DSM-5 adds hoarding and excoriation disorder—a diagnosis for people who compulsively pick their skin. The APA also rejected several proposed disorders, including parental alienation syndrome, hypersexual disorder, and anxious depression. While the APA emphasized that the revisions—like all changes to the DSM—are intended to clarify diagnostic criteria and improve consistency in diagnosing, mental health advocacy groups argue that many diagnostic criteria have been loosened and that the DSM-5 will increase the number of people diagnosed with mental health conditions.

Which changes to the DSM did you find most controversial? Please share your comments below.

References:

  1. Asperger’s syndrome dropped from American Psychiatric Association manual. (n.d.). MedPage Today. Retrieved from http://www.medpagetoday.com/Psychiatry/DSM-5/36206
  2. Gever, J. (n.d.). DSM-5 wins APA board approval. MedPage Today. Retrieved from http://www.medpagetoday.com/Psychiatry/DSM-5/36206
  3. Gupta, P. (n.d.). Controversial changes to stay in DSM-5. Salon. Retrieved from http://www.salon.com/2012/12/02/controversial_changes_to_stay_in_dsm_5/
  4. Spiegel, A. (2012, November 30). Weekend vote will bring controversial changes to psychiatrists’ bible. NPR. Retrieved from http://www.npr.org/blogs/health/2012/11/30/166252201/weekend-vote-will-bring-controversial-changes-to-psychiatrists-bible

Old headstone in field“Owning up to the ‘good-bye’ that is built into our finite human existing makes possible the saying of an authentic ‘Hello!’ ” —Robert D. Stolorow

For most people, death is something that will happen to us someday. Not today. Not tomorrow. But sometime in the future, distant enough that we need not concern ourselves at the moment. In other words, we ignore it and forget about it. Yet in doing so, we forget who we are. Death is not just something that happens at the end of life. It is a part of us throughout, whether we confront it or not. In facing death, traumatic as it may be, we cannot help but change, grow, and clarify what it is that we love and care about most. The preciousness of time comes to the fore.

It’s true that people understand death in different ways. Does the soul continue on or does it die with the body? Is there life after death, or does it end with this one? Whatever one’s beliefs about the hereafter, death is the end of life as we know it. When a loved one dies, he or she departs from us in a way that is undeniable. We are forced to notice their importance to us, as well as everything we value. In romantic relationships, as often depicted in romantic comedies, each partner’s love becomes inestimable often only after it has been tested with the threat of loss.

Confronting death as an ever-present reality means mourning the loss of all we hold dear. It is no mystery that death is not a favored topic for cocktail conversation. It’s often depressing and lacks a joy and levity that is so much a part of life. When a loved one dies, we often say that he or she “passed on,” avoiding the harsh word of death, attempting to soften the painful reality for the sake of our loved ones. Few people choose to spend their lives isolating themselves with thoughts of death. It is isolating because it forces us to depart from ordinary social values.

David Fincher’s film Fight Club (1999) is a dark and violent satire that exposes the superficialities of commercial life and hints at the meaninglessness of life altogether. And yet the film holds great potential to discover meaning. The antihero Tyler Durden recruits a large number of young men into his “fight club,” and insists they shun the values associated with ordinary social life, particularly advertising. “You’re not your job,” he preaches. “You’re not how much money you have in the bank. You’re not the car you drive. You’re not the contents of your wallet.” Durden pulls these young men away from their ordinary day-to-day living into a profound confrontation with themselves. He prescribes to his followers that they let “what truly doesn’t matter slide.” Fincher’s film hints at the sort of existential confrontation I’m trying to describe. Durden insists to his pupils, “You have to know, not fear, that someday you are going to die.”

It would be a mistake, however, to conflate the commentary on death in Fincher’s fight club with my own. Fincher’s Durden develops a following, a cult of sorts. He removes people from the social conformity of ordinary life only to foster a new conformity to the cult of fight club. Confrontation with death, whether through the loss of a loved one, escaping the threat of physical harm, or simply philosophical contemplation, is always traumatic. It leaves one disoriented, forcing us to abandon the thoughts and beliefs that root us in everyday life. Fincher’s fight club finds its way toward destruction and a certain kind of meaninglessness, where there’s little, if any, light at the end of a dark tunnel. The commentary on death in Fight Club treats life recklessly, not carefully. In coming to terms with death, life needs to be respected in order to preserve the opportunity for growth. It is then that from darkness may come great illumination.

Professional women shaking handsYou entered therapy feeling broken, lonely, anxious, dissatisfied with your relationships and your career. Now you feel whole and healthy; your relationships have improved, and you’ve made some professional changes that have led to a more fulfilling career. You feel good about yourself. Life isn’t perfect, but you have come to accept these imperfections, and you feel equipped to handle life’s challenges when they come your way. Congratulations! The time, effort, and willingness to openly and honestly explore the most complex and painful areas of yourself and your life have paid off. Therapy worked. Now what? You have a standing weekly appointment with your therapist, and you have probably developed a strong therapeutic alliance with him or her. But lately you have noticed that you don’t feel a need to go to therapy and you struggle to find ways to fill the hour. These are some strong indicators that you are ready to leave therapy.

For most people, therapy is not forever. Very few people have reason to be in therapy for life. In fact, many of the people who make therapy a way of life are therapists. They have a personal and professional responsibility to maintain high levels of self-awareness. They must take precautions to ensure that their issues are not getting in the way of helping their clients, and that they are not letting their clients’ issues prevent them from living their own lives. Weekly therapy sessions can create the time, space, and support for therapists to do just that.

[fat_widget_right]

Certainly, there are some people who are not therapists who also come to view therapy as a way of life. These people are often deeply dedicated to self-growth, and therapy may provide the support they need as they pursue constantly evolving personal goals. However, the vast majority of people who come to therapy do so with the intent of getting help with something specific. Whether it is something as broad as wanting to feel better or something as narrow as making a decision about a career move, people usually bring a specific goal to therapy. For some, these goals can be achieved in a few short months, while for others, it can take years. But ultimately there is a resolution and they feel ready to end therapy. The question then is how to do it.

One of the things people find most useful about therapy is that there is nothing you can’t talk about in a session—including your relationship with your therapist. In fact, a growing body of research indicates that much of the positive change produced by therapy comes as a result of the therapeutic relationship. For example, if your relationships improved while you were in therapy, it is likely, in part, because you learned new ways of being in relationships by actively participating in your therapeutic relationship. So take the well-honed skill set that you developed in therapy and open a discussion with your therapist about ending the therapeutic relationship.

This will likely come as no surprise to your therapist. He or she knows what you came in to work on and knows that you have achieved your goal. Plus, this is a natural part of the process—all therapists in training learn about how to help clients work through this final stage, called termination. This is a prime opportunity to review the goals that brought you to therapy and to reflect on the growth that allowed you to accomplish them. This part of therapy is kind of like a graduation ceremony—it is an opportunity to step back, look at how far you have come, and revel in your success. And, as with graduations, it is an opportunity to ponder and plan for what comes next. Part of termination involves reinforcing the coping skills that evolve during therapy and reminding clients to continue to draw upon them in the future. Another important part of this process is to identify indicators that may signal the need to return to therapy in the future.

Finally, working through the process of termination with your therapist will allow you the opportunity to process the ending of a powerful and unique relationship. While this is a deeply genuine relationship, it is also one that exists within strictly prescribed boundaries—within the therapist’s office during appointment times. Of course, there may have been phone calls and additional meetings scheduled during times of crisis, but there isn’t a healthy way to continue the relationship you have formed with your therapist outside of therapy. Feelings of grief, loss, and anxiety about ending the therapeutic relationship often come up, and termination is designed to address these feelings. Like all aspects of therapy, this can be a difficult process, but seeing it through can be invaluable in helping you continue to develop and implement the kind of sophisticated relational skills that enable you to have deeper, more meaningful, and authentic relationships.

Man with his head down in his arms

I’ve been thinking about grief, mourning, and loss a lot lately. It shows up as a theme in my work as a psychotherapist all the time. I’ve also been studying the literature on methods of providing grief counseling and grief therapy. What I realize is that my sub-specialty in this area is not limited to working with individuals who have experienced the death of a loved one. It is more far-reaching than that. Judith Viorst wrote a wonderful book, Necessary Losses: The Loves, Illusions, Dependencies, and Impossible Expectations That All of Us Have to Give Up in Order to Grow, in the mid-1980s in which she described the losses we experience along the life cycle. It’s a must-read for people who are unfamiliar with it.

[fat_widget_grief_right]

I would venture to say that most of the work we as psychotherapists and spiritual counselors do is about coping with loss. We help our clients grieve about their losses, whether it’s loss of youth, money, job, socioeconomic status, or friends. They need to be helped to grieve the loss of hopes and dreams. They even grieve the loss of fantasies and illusions, although much of this happens unconsciously. In this case, our job as psychotherapists and counselors is to help them recognize that they are in mourning and provide tools to cope. The idea is that grief takes up a lot of psychic space in our beings, and it is only by coming to terms with our losses that we create room for the new.

The focus of this article is how many people typically grieve. The ways—which are not healthy—include:

These are just a few of the many ways people attempt to fill the space loss creates in their psyches and spirits. With methods such as these, the loss is not completely grieved or grieved at all. The feelings may even become worse, leading to a cycle of self-harming behavior.

So what predisposes someone to engage in the self-harming and ultimately unsatisfying behavior described above? There can be many factors, including low self-esteem, a history of untreated anxiety and depression, an inability to express feelings—especially difficult ones such as anger—and the lack of a support system. There are also more complex reasons involving one’s family of origin, including trauma in early childhood and the absence of a secure connection with early caregivers.

This sense of emptiness and lack of safety makes loss intolerable rather than simply painful, and it is this inability to tolerate it that leads to the behavior described above.

In addition to these internal factors, society in general and specific cultures in particular make grieving difficult. Part of this stems from our lack of recognition of the universality of loss, i.e., as something that permeates all aspects of life and isn’t just about death. In addition, we have become a culture of short-term fixes—the “just-get-over-it-and-move-on” philosophy. This puts pressure on individuals to minimize their sense of loss.

Finally, there is the over-arching reason grief is given short shrift. It makes many, if not most, people uncomfortable because it touches unhealed grief in themselves.

Next month, I will discuss some effective and healing ways to cope with grief and loss.

 

Man looking out hotel window

The pain of divorce is often unbearable. The experience can be so awful that you wonder whether it would have been easier to stay married or even to be dealing with some other horrific life event like death. The depth of pain is often surprising, particularly when you know you don’t want to be married anymore. What many people forget is that divorce is just a fancy word masking what is truly a broken attachment between two people. Divorce is more than separating assets and belongings.  It’s the severing of a very strong bond founded on deep feelings of dependency and need. Believe it or not, you developed an attachment to your partner over the course of dating and marriage that connected you on an emotional and physiological level beyond what you realized.

When two people get married they are vowing to be committed and to love one another, but they are also pledging to become “attached.” This attachment is unspoken and unknown to both, but it is the most powerful connection anyone can have to another person in a love relationship. According to author Helen Fischer in her book Why We Love, our “cuddle chemicals,” namely oxytocin and vasopressin, contribute to the sense of closeness and attachment couples feel toward each other in a love relationship. These bonding hormones promote a sense of fusion between lovers that deepens attachment and a sense of oneness. This biological phenomenon explains the depth of devastation felt when the attachment is broken and the physiological symptoms that become activated when attachments are severed. The response is often primal, leading to thoughts, feelings, and behaviors that might never surface in any other context of life.

The end of a marriage is one of the most emotionally painful human experiences. Thinking about the experience of divorce within the context of attachment generates a greater sense of empathy for what you might be feeling. It explains the levels of rage, vindictiveness, grief, and despair that so often accompany this common life transition. We too often think of divorce as a noun or a verb, but it is actually a relational trauma that has a physiological and emotional effect. You may be creating more suffering for yourself by resisting what you are feeling or telling yourself that you are overreacting.

Recognize that the end of your marriage represents much more for you than you may realize. If you were a small child and the person you depended on most was suddenly unavailable to you, there is no doubt you would have a strong reaction. The end of your marriage is no different. Give yourself the time and space to heal and repair. You are not damaged, just temporarily devastated, and the recovery will come with time. Divorce is not just a matter of the heart but an experience that impacts the whole person on a multitude of levels. 

 

 

 

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.