TALKING ABOUT GRIEF

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Does talking about it help?

There’s no one answer. We’re all different.  The only thing you and I have in common is that we’re both human.  In other respects each of us is, miraculously, one of a kind. So people experience loss of a loved person differently.  The searing pain may be the same in every bereaved heart. There the similarity probably ends.

There are differences between loss of one parent and then of the remaining parent, between loss of a brother or sister and loss of a child or of a husband or wife. Family situations also vary among the grieving survivors.  There may be strong familial support or no family at all, loving friends or none. Often when the survivor of a death is getting on in years, the loving friends who might have been there are already dead themselves.

For the most part, men and women also seem to differ in their response to what has happened. Many men may feel they can tough it out alone, or that their loss is too private to share. Some simply lack the habit of being able to talk about feelings.  There are women who also feel uncomfortable speaking openly about private matters. However, these appear to be in the minority.   In the five or six walk-in bereavement group meetings and two six-week bereavement group sessions I attended after Bill died, I encountered only five men — two in one of the six-week groups and three others at separate walk-in sessions. Three were widowers and two were sons who had lived all their lives with their mothers.  Everyone else I met was a recent widow, or a sorrowful daughter or sister.

Therefore anything I say here about the value of talking about one’s great loss will not be useful for everyone.  I have at least one friend, no shrinking violet, who went to a couple of meetings after her husband died at too young an age and felt bereavement groups would not help her deal with the hand she’d been dealt.   Nonetheless, since I’ve been quite frequently asked why I attended (and now and then still do attend) such meetings, I’m going to set down here my experience with the benefits of going.

At the time Bill died last May, the very existence of bereavement groups hovered only lightly on the periphery of my consciousness as a vague notion they provided spiritual solace for church members. Since I’m not only nominally Jewish but entirely without spiritual faith of any kind, I would therefore not have been in any way comforted by the references to Jesus and God I expected would be offered by such groups. However, on one of his last days of consciousness before the morphine required for intubation knocked him out, Bill mentioned them. Although a psychiatrist by training, he had always favored talk therapy over pharmacology wherever medication might not have been absolutely necessary. Concerned even on his deathbed about my being alone in Princeton after he left me, he tried to think of what might help. So of course his suggestions included a place where I could talk it out.

My own instinct, not dissimilar, was to find a psychotherapist instead of a group — of necessity one who would take Medicare.  Throughout my life, it was always psychotherapy that helped me survive and surmount some very real difficulties.  Afterwards I would say, in jest (but it was also true), “I can’t leave a husband until I have a shrink, and I can’t leave a shrink until I’ve found another husband.”  I’ve also said, not in jest (but equally true), “I don’t know what I think till I hear what I say.”  Last May I wasn’t leaving anyone; he was unwillingly leaving me.  But the default position was the same.  I was going to need someone to talk to.

When I had sought therapy before, I was working and could pay.  Now I wasn’t working, and couldn’t pay — at least not for long.  In the intervening years, it has also become hard to find a therapist (let alone a psychiatrist who still does talk therapy) willing to settle for what Medicare will approve per session.  Eventually, with the help of my internist, I did find such a person. It is a great and much appreciated luxury for someone like me, needing to talk or write about what is going inside, to be able to sit down once a week with someone absolutely supportive and non-judgmental who for fifty minutes at a time exists only to listen and offer an occasional comment or suggestion.  But it took time to find her.  In the meanwhile, there was a nonsectarian bereavement group meeting once a month at the Princeton Senior Center where you could just walk in without registering or making a prior commitment.

I’m not a group person.  I like one-on-one, not only in therapy but with the people to whom I can be open. So it was with some trepidation that I showed up at the Princeton walk-in group on May 16, ten days after Bill’s death.  There were about eight people in the room, plus the group leader, who was a licensed social worker and part of the local hospital hospice staff, and also the hospital chaplain, a young woman newly pregnant. Despite my hesitation at the presence of the chaplain, she said nothing remotely “spiritual” at any point during the hour and a half we were there. Her function was to co-direct the discussion with the leader and, I suppose, to be available with her chaplain hat on for anyone who sought her out privately afterwards.

The group was part of the hospital’s outreach to the community. We sat around a long table on which there was a large box of Kleenex, introduced ourselves, identified the person we were there for and when he or she had died.  That was all we had to say, unless we felt like saying more. Almost everyone in the room said I had come too soon.  I didn’t think so. “Soon” is when you are raw and bleeding inside.  “Soon” is when you most need some kind of triage.  Even if you just listen to other people talk about how they are hurting without saying anything yourself, it helps. It helps to hear you’re not by yourself in feeling such extreme pain and fear. (Some people don’t admit the fear, but you can hear it in what they say.)

A number of acquaintances have said to me they didn’t need groups because when they were in that dark place hollowed out by death they were able to talk to family and friends.  I didn’t find talking to family and friends to be the same.  Even when you’re being deluged with phone calls, and invitations to dinner, and visitors bearing flowers and food, the callers and visitors don’t really want to hear too much about how you’re feeling.  You can sense their uneasiness as you speak. They make sympathetic sounds and nod and offer tissues, and then try to turn the conversation to other things, either to distract you from your sorrow or because they’re uncomfortable with such raw feeling.  It takes someone who’s been there or — better yet — who’s there right now.

Moreover, you get about thirty days of undiluted sympathy from the non-bereft.  Then you’re expected to make efforts to return to regular life.  Even quite good friends are capable of asking, “So, how are you now?” or, “How are you doing these days?” or, “Any plans to get away for a while this summer?” They also make every effort to avoid mentioning the person who has died. His or her name simply disappears from what they have to say.  They mean well.  But they just don’t get it.  And they don’t comprehend your inner confusion, if you try to explain it to them:  Are you really missing him (or her) so much as the weeks and months begin to pass?  Or is it the life you built and lived together that you miss?  Nor do they grasp the hot rage that alternates with your despair: The death wasn’t the fault of the disappeared, so why are you so angry, and (for God’s sake) at whom? After a while, you realize it’s futile to reach the uninitiated.

You can talk about all that in a bereavement group.  The others may come from other professions, other social circles, backgrounds, cultures, faiths…may have other vocabularies, may be less able than you to articulate what’s going on with them inside. But they will listen respectfully and with interest to what you need or want to say. They will have felt what you are feeling, or will begin to feel it as you talk about it and they let it well up.  You (and they) are in a place where it’s safe to let it out.

You also learn coping strategies, or work them out for yourself, from listening to those a little further away in time from death than you are. In addition to the good ideas you pick up, you may also on occasion feel privately superior to some of the group participants.  For example: one poor fellow in his fifties whose mother had died several months before said he wandered around the local supermarket in the evenings although he had no need to shop, so as to feel himself among other human beings. Although I felt sorry for him, I knew at once that’s something I simply would not do. And if you’ve come to the meeting with the sense you’ve been crushed by loss, perhaps beyond repair, hearing about such desperate measures may energize you to find a more palatable and self-respecting alternative.

Some people even make new friends from among those who are sharing their experience.  A mini-group of four who participated in one of the two six-week group sessions I attended  last summer banded together for the purpose of not being alone on Saturday nights.  They pick a local movie by e-mail and all have supper at a nearby restaurant before the movie begins. I myself would not find a shared loss sufficient basis for pursuing friendship outside the bereavement group unless there were other interests and points of view in common.  But it seems to give these four considerable comfort, now that they are all without partners, to spend “date night” doing something together that they did with their partners before.

Why do I still occasionally go to bereavement groups now that it’s six and a half months since Bill’s death? Because I’m in no way out of the woods yet.  The rawness of the injury (and death of a partner is a severe injury to the survivor’s sense of self) has scabbed over. But in my case, anyway, the depth of the sorrow seems to have been somewhat deferred, given the fact that I had to spend June, July, August and September winding down Bill’s affairs, getting a condominium townhouse ready for sale, marketing it, looking for an apartment to live in after the sale, coordinating both contracts so that the apartment contract was contingent on the successful sale of the condo, downsizing, working with a contractor to somewhat alter the apartment before the move, and then finally moving.  (Some of that perhaps to be recounted in future posts.) Such concentrated activity left only early mornings and nights for unrestrained crying. So it is just now when I am “settled” again that I have the relative leisure to let myself fully experience how I feel as I embark without him on this new life into which I was thrust against my will.

And for where I am in what could be called the grieving process, a group can continue to be helpful. I’m the sort of person who responds to what someone else has said rather than initiating a train of thought myself.  Last Monday, at a walk-in session, I responded to a widow who told us how she was sorrowfully trying to recreate the Thanksgiving she had had with her husband for so many years — with a thought I hadn’t been able to formulate clearly before she spoke. I said I felt as if the life I had shared with Bill now seems to me like a play in which I was suddenly left onstage without the other player.  But half a year later, I’m not in that play anymore.  The scenery’s been struck and they’ve mounted another play on the stage, with new scenery.  I certainly remember the first play. I know all the lines. And I dearly wish I were still in it with my co-star.  But I’m not.  He’s disappeared. Now I’m the lead character in this new play.  Except I’ve only been given the first few pages of the script and I have no idea at all yet what the author,  whoever the author is  –me? — has in mind.

That’s exactly how I’m feeling this Thanksgiving.  But I don’t think I could have discovered such an apt and clarifying metaphor for it if I hadn’t been at the bereavement group meeting last Monday. I’m sure there will be post comments from people who’ve had other, more negative, experiences with bereavement groups. But as I said at the beginning, and as Bill always said when someone said or did something that flummoxed us, we’re all different.

I wish you a warm and tranquil holiday weekend.

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TRUMP AND LIFE

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Yesterday I declared I wouldn’t be commenting on the election. However, I just came across a piece by Adam Gopnik, published four days ago by The New Yorker Digital News Desk, called “Talking to Kids About Trump’s Victory.” Gopnik’s last paragraph strikes me as so exactly right — not only about Trump arriving after eight promising years of Obama but also about life in general, especially as I have been experiencing it recently — that I can’t resist quoting it.

The lesson of history—one of them, anyway—is that there is no one-way arrow in it, that tragedy lurks around every corner, that the iceberg is there even as the mighty Titanic sails out, unsinkable. [italics mine] Having a tragic view of life is compatible with having a positive view of our worldly duties. This is a big and abstract thought to share with children, of course, and perhaps, like so many like it, it is teachable only as a pained—at this moment, acutely pained—daily practice.

Is a quote a comment?  Probably.  Is life really tragic?  If you live long enough, it does seem so.  Must we nevertheless keep a positive outlook on our familiar duties and pleasures, and take as much comfort as we can from them? What other choice is there?

BIG WORD FOR FEELING AWFUL

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[Whatever the headline may suggest, this post is not about last Tuesday’s election.  My feelings about that are indeed awful, as if someone had suddenly and unexpectedly died, except it’s not the heartrending death of a someone but of political, ethical and perhaps even personal life as I and everyone I know has come to expect it. However, everything that can be said at this point has already been said, by other bloggers, columnists, friends.  As for the frighteningly uncertain future, we can only grit our teeth and wait for whatever comes next. So I am returning here to last May, after Bill’s death and my visit to the undertaker.]

Bill died on a Friday. On Saturday morning, of necessity, I visited the undertaker/funeral director. I then got myself home and didn’t go out until Monday.  There were comforting phone calls, which made me sad when they ended because I was alone in the house again. There was also cuddling with the cats and raw sorrow.  It felt as if a large part of me had been cut away, leaving a hollowed-out bleeding cavity. Solicitous acquaintances sent flowers.  I had no desire to eat (although I knew I should), and wished I could sleep (but couldn’t).  The refrigerator was still full of Orgain, a packaged drink somewhat like Ensure but designed by a doctor undergoing treatment for cancer and allegedly composed of more nutritious ingredients, which Bill had been able to consume even when the medication he was taking to slow the progression of his pulmonary fibrosis removed his appetite and made him nauseous.  I survived the first weekend on two or three daily vanilla Orgains.

I did go to bed early and lay there until it was light again, but if I slept (and I probably did, in fitful bits) I don’t remember it. I do remember my law-school-trained mind spinning like a kaleidoscope gone crazy, unable to focus either on my misery or what I had to do next on Bill’s behalf.  Which was to (1a) sell the red Honda he had driven; (1b) try to return to the distributor for credit his newest and virtually unused portable oxygen concentrator,  five pounds lighter than the one Medicare had provided — for which he had paid nearly $2000; (1c) close his credit card accounts; (1d) notify his insurers of his death; and (1e) verify that I would not need to probate the will, since New Jersey doesn’t require it if the decedent owned nothing solely in his own name at the time of death. There was also what had to be done, all by myself, on my own behalf. Which was to (2a) sell the condo as soon as I could, since it was both too big and too expensive for me to maintain alone much past the end of the calendar year without seriously dipping into capital; and also to (2b) find another place for the cats and me to live as soon as the condo was sold, although the money to buy this “other” place, when I found it, was solely the equity in the still unsold condo because I was pretty sure I didn’t qualify for another mortgage while I still had one. (A few weeks later, I found out I was right.  I was coldly informed by loan officers at two separate banks that I would need to show at least $10,000 in monthly income to carry the two mortgages, even for only the three months or so before the condo would presumably sell.  Hah.  That was not something I would ever have been able to do, even when I was working.)

The (1a-1e) through (2a-2b) in the prior paragraph is of course so neatly organized because I am writing this piece six months later; organization or any kind of  plan was completely beyond me that weekend.  My mind lurched from “close his credit card accounts” to “see if I can get a mortgage” to “should I take the car to Honda or try to sell it myself” to “do I know a lawyer I can consult about the will who won’t charge me” to “the condo is an unsightly mess of medical equipment and books all over the floor” to “how could he leave me to deal with all this by myself?” to “I need more Orgain from Amazon, chocolate flavor this time.”  Then one of the cats, still missing Bill, would come to the bed in the middle of the night to be scratched, petted and comforted. And I would cry, in the dark, into her fur.

Everyone who called advised doing nothing for a while until I felt stronger.  That was good advice. But the Type A person I also am thought: What do they know?  “Listen to what your body wants,” said Bill’s niece, a psychotherapist practicing in Israel.  Well, all right.  Unfortunately, by Monday — when I attempted to walk to the brick mailbox stand two driveways away from mine — I realized I could move only very slowly and was wobbling. Was my body trying to tell me something? I began to eat again, carefully, because I knew I should, and also because kind acquaintances were deluging me with offers of meals at their house, meals at restaurants, prepared meals brought in (one even vegan and surprisingly tasty) — none of which I could in good conscience refuse — and also because a survey of the refrigerator and pantry cabinet revealed so much food stored there to tempt Bill’s appetite that I would have to give it away, throw it all out or begin consuming some of it.  Sleep didn’t come as easily as the meals.  And the trips to the mailbox were becoming even more difficult. By the end of the first week, I was making them only every other day.  (Since Bill was the King of Catalogues, that meant the box was so stuffed when I did eventually open it that I hardly had the strength to pry out its contents and scraped the outsides of my fingers raw on the metal sides of the opening.)  A friend who picked me up to feed me rotisserie chicken and salad had stone slabs for steps up the grass from her driveway to the house. I had to ask her to let me clutch her arm to make it to the front door.

This was both embarrassing and worrying.  I was all alone in Princeton.  Although they were warm and supportive on the phone, one son lived in Florida and the other shuttled back and forth by train between work in D.C. and weekends with his still-young children and wife in New York.  If I became too weak to take care of myself, not to mention all the things needing to be done, then what?  By the time I stepped out the door to get the mail a week to the day after Bill had died, my heart was pounding loud and frighteningly fast, I gasped for breath as if I too had suddenly developed pulmonary fibrosis, and I was so dizzy the ground under my feet spun around. As I proceeded very slowly towards the box with legs far apart, like Charlie Chaplin, to keep some kind of shaky balance, I felt I might be on the verge of dying — not that very minute, but soon.  Although my head was still revolving like a top, I was able to grasp and hold on to one thought:  Call a doctor before it was too late.

Easier said than done.  For nine and a half years, since coming to Princeton, Bill and I had been seeing an internist highly recommended by the nurses in the major medical practice nearby as the most patient-friendly.  Dr. L. was indeed apparently much interested in each of his patients, at least for the time allotted him by the insurance companies, and even seemed to remember just about everything about you when you showed up for bi-annual checkups without first having to review your chart in your presence. But as we each grew older, and more symptoms of this and that surfaced, Bill pulled away. He was mostly seeing specialists by then, anyway.  I hung on to Dr. L. until last year, although Bill kept urging me to switch to Dr. G., another internist in the same practice whom he liked much better on the one or two occasions he had consulted him.

The cause of Bill’s disenchantment with Dr. L., and eventually mine, was that patient-friendly as he was, Dr. L. was a worrier. He was also perhaps over-impressed by our academic and professional credentials and shared all his proactive medical hypotheses with us.  If there were a symptom or a complaint, he not only knew all the conditions and diseases of which it might be a harbinger, which would need to be tested for, but would share all this (potentially scary) thinking with us.  In my seventies, I was sufficiently healthy that Dr. L.’s proclivities as one’s medical advisor didn’t really bother me. Later it did, very much. By then I had enough to worry about, without contemplating dire possibilities that might not come to pass.  But that’s another post, for another time.  Suffice it to say that last March, Bill prevailed, I switched to Dr. G., and obtained an appointment for the end of May.

Thus, in the middle of May when I suddenly needed him, Dr. G. had not yet met me. Moreover, a phone call revealed he was completely booked through the end of June, and certainly couldn’t squeeze in a new patient he didn’t yet know.  Although no one suggested it, I felt unable to return to Dr. L.  Nor would I under any circumstances take myself to the Princeton ER, given my recent experiences at that hospital.  (See “After Death, What?” TGOB, July 29, 2016.) However, Dr. G.’s appointment secretary was very kind when she learned my husband had recently died and I felt as if I were going to die too.  Her husband had died two years previously and she had felt exactly the same way.  She would try to find someone else to see me. (I did hope it wasn’t going to be Dr. L. but kept that to myself.) Good as her word, she called back an hour later with the name of Dr. S., who had recently joined the practice and therefore had an opening, five days from then (no, not sooner), at 8 a.m.

Beggars can’t be choosers.  In the meanwhile, I googled Dr. S.  His photo showed pink cheeks, a big smile on a round young face, lots of neatly combed dark hair; he looked as if he’d just emerged from college. Although he hadn’t gone to any of the medical schools known to me through fifteen years of living with Bill (a psychiatrist), young Dr. S. had practiced for a couple of years in Philadelphia, could probably determine whether I was dying or not, and could then hand me over to the appropriate specialist(s) to treat whatever was wrong with me.

Dr. S. looked exactly like his picture.  He might have been a classmate of  one of my sons when in their twenties.  Still, he was an M.D..  I explained why I was there. Husband died ten days ago. Heart fast and pounding. Unable to breathe. Legs like cooked spaghetti.  So dizzy the world was turning round and round.  No balance.  Unable to think a straight thought.  “Well, let’s see,” said young Dr. S. soothingly, reaching for his tools.  My blood pressure was normal.  My heart rate was normal.  My blood oxygenation level was 98-99 (so the breathing was normal).  “Then why am I feeling like this?” I demanded. “As if I were going to die?”  Young Dr. S. must have been a very good student in whichever medical school he had attended.  He knew exactly what ailed me.  It sounded as if it had come right out of a textbook.

“Somatization!” he declared.  

He meant it was all psychosomatic.  The pounding heart, the breathlessness, the vertigo, the loss of balance, the inability to focus.  I had never heard the noun form before, but if there’s a medical adjective, there’s usually a big and latinate related noun. “It’s just a reaction to your loss,” he said to me in a voice appropriate for addressing a small child or someone not quite with it.

And what was I supposed to do with this information? Learn to live with it? Dr. S. mentally turned pages till he reached the one that dealt with treatment for the grieving patient. He then told me I needed sleep and food. I was to get eight hours of sleep, and if I couldn’t fall asleep when I went to bed, I should get up and read till I felt sleepy, and then try again.  I was to eat whatever I wanted, even if it was french fries, without worrying about it, because I now needed the calories.  I suppressed various impulses to tell him I wasn’t stupid and instead listened impassively, not quite the good and grateful patient contemplated by the medical textbook but close enough. What was the point in pushing it with young Dr. S.?  He was doing the best he could.  He also told me to exercise. “Even if I’m moving like Charlie Chaplin, but more slowly?”  Yes, exactly.  And then I would start to feel better.  Well, perhaps that’s what the medical textbook said. “Could you also write a scrip for ten days of a mild sleeping pill?” I asked.  “To get me through till my appointment with Dr. G.”  No, young Dr. S. feared I might become addicted.  If I really couldn’t sleep after the getting up and reading for a while, I might try Benadryl, which is over-the-counter and not (he said) addictive.

While waiting in line at Rite-Aid to pay for the Benadryl, I thought about Dr. S.’s big word for feeling like death.  Somatization. I had never believed that symptoms of what were later diagnosed as real physical complaints, like chronic fatigue syndrome or Lyme Disease, were psychosomatic, even if they were first dismissed as such.  Apparently I was wrong. It seems in some instances the body does speak up to tell you what you’re really feeling.  Mine, for instance. It was saying that all of me was suffering from mortal grief, even where my heart was actually beating regularly and my lungs actually functioning normally. I had just been been in shock too great to realize it.

And that did make me begin to feel better.  Or at least less worried. The Benadryl was a bad idea; one tablet knocked me out for eleven hours and left me woozy for twenty-four.  But after that I began to fall and stay asleep without help, except from the cats.  So although I continued to weep often and spontaneously when by myself, I had become somewhat more optimistic about being able to manage living without Bill, even if unhappily,  by the time my scheduled appointment with Dr. G. rolled round.

The following week, the undertaker called me to come pick up Bill’s ashes. For the $3,000 I had paid him he probably would have kept them for a while, had I asked. But better sooner than later, and be done for good with that unctuous and falsely sympathetic man. The bag containing the plastic urn seemed surprisingly heavy when I picked it up, although Bill hadn’t been tall or big-boned.  Regretfully, I needed Mr. Unctuous to carry it to my car for me.  I hadn’t thought to bring a cane (although there were eight or nine of Bill’s, in various styles, in the house) because I wasn’t used to needing one.  But I was still afraid I might fall if I held the heavy bag while going uncertainly down the incline from the funeral home door to the curb.  However, I wasn’t dizzy anymore, and that was something.  Besides, Dr. G. had written a scrip for physical therapy to get me stronger again and I already had a first appointment scheduled.  He had also given me another prescription, for thirty days of a mild sleeping pill.  I did fill it, but by then I no longer wanted or needed sleep aids. Six months later, the thirty little pills are still in the drawer of my bedside table.