Friday, March 22, 2013

The Myth of Grief and Loss


They all claim to work quickly to relieve the physical symptoms of pain and we expect to feel better within minutes. Living as we do in a culture having no tolerance for pain of any kind — especially the physical, psychological, social, and spiritual agony of grief — it’s no wonder that people who are grieving feel abnormal when they can’t stop their pain.

“No! This can’t be happening!” is our initial reaction when confronted with devastating news, as we resist facing the awful truth. This phase of protest may be present for months (in extreme, complicated cases, for years), particularly if the death was sudden, and especially if the bereaved did not see the person’s body after they died. People in protest may try to avoid any evidence that contributes to acknowledging the painful reality of this loss.

Among those whose mourning rituals permit viewing of the deceased, such viewing is an important component of the work of grief, as it confirms the fact that the person has, in fact, died. And yet, more and more families are opting for direct cremation with no viewing. If the bereaved were not present when the person died and then refuse or decline to see the deceased prior to cremation or burial, complicated or protracted bereavement may result. Many will report fantasies that their loved ones are not really dead; that it was a big mistake. “Maybe they exist on an island somewhere” (these authors have coined that delusion the “Gilligan’s Island Syndrome”), or, “Perhaps they have amnesia and are wandering around aimlessly searching for their identity.”

Once the psyche acknowledges the sad reality that a loved one has died, profound despair may follow, along with symptoms that constitute a major or “clinical ” depression. While the symptoms may appear identical, these authors assert that treatment of depressive  symptoms from bereavement may need to be quite different from treating depressive symptoms from other causes.


While medications may help to allay some symptoms of anxiety and depression, we hear over and over from those taking tranquilizers and antidepressants that their symptoms persist or, in some cases, are worse. As noted bereavement therapist, Peter Lynch, MSW, said at an annual Holiday Service of

Remembrance, referring to the many feelings associated with grief, “The only way through it is through it.” Medication doesn’t make the pain of grief go away. Clients need to understand this important point.

Most people expect to feel better after the first year following a loss and they become frightened when they instead feel worse as they approach the second year. For anyone grieving a significant loss, and especially for someone who has lost a spouse or life partner, the first year is a time of learning to adjust and physically survive. Consider noted psychologist Abraham Maslow’s “hierarchy of needs” (1998).

As Maslow observes, the basics of food, clothing and shelter must be established as a foundation to allow individuals to proceed on a path toward self-actualization. Whether real or imagined, the majority of our clients who have lost their life partner spend much of the first year worrying about their basic survival needs. Once these issues have been resolved, the emotional impact of the loss may dominate the subsequent year. This is when profound feelings of sadness may arise, which may be especially frightening if they are not expected or perceived as “abnormal” or “pathological.” In this emergence of feeling, the meaning and significance of the loss emerges more clearly. The press of business has subsided and the bereaved person is left with what the “now what do I do with the rest of my life” questions and fears.
J. William Worden, professor of psychology at Harvard Medical School, developed a model that he calls the “Tasks of Mourning” (1991). His premise is that grief is work. It requires commitment and active participation on the part of the person who is grieving, and, these authors would add, on the part of those who wish to help them. The tasks are:
  1. to accept the reality of the loss;
  2. to work through to the pain of grief;
  3. to adjust to an environment in which the deceased is missing; and
  4. to emotionally relocate the deceased and move on with life.
Worden’s task-focused model offers a motivational framework for grief work. Time, in and of itself, does not heal all wounds. There is no magic in the one- or two-year anniversary date following a loss. Moreover, this model acknowledges that death does not end a relationship. Emotionally relocating the deceased is a dynamic process that will continue throughout the life cycle. Personalized, meaningful commemoration and ritual may facilitate this process.

Love endures death. The loss of a significant loved one is something that is not gotten “over.” Words like “closure” may evoke anger and hostility on the part of the bereaved. Things (doors, lids, bank accounts) are closed. How, then, does closure apply to a relationship that was, is, and always will be significant? The work of grief involves learning to live with and adjust to the loss. According to

Worden, there may be a sense that you are never finished with grief, but realistic goals of grief work include regaining an interest in life and feeling hopeful again.
Redefining and recreating a purposeful, meaningful life poses enormous physical, social, psychological, and spiritual challenges to our bereaved clients. Educating, supporting and coaching them through the tasks of mourning may help to rekindle their desire to live and to thrive.


References
Maslow, A. (1998). Toward a psychology of being, 3rd edition. New York: Wiley.

Worden, J.W. (1991). Grief counseling and grief therapy : A handbook for the mental health practitioner, 2nd edition. New York: Springer.

 

Levels of Inflammation

Dwelling on stressful events can increase levels of inflammation in the body, according to a new study.

Researchers from Ohio University discovered that when study participants were asked to ruminate on a stressful incident, their levels of C-reactive protein, a marker of tissue inflammation, rose.
The study is the first to directly measure this effect in the body, according to Dr. Peggy Zoccola, an assistant professor of psychology.

“Much of the past work has looked at this in non-experimental designs,” she said. “Researchers have asked people to report their tendency to ruminate, and then looked to see if it connected to physiological issues. It’s been correlational for the most part.”
For this study, the research team recruited 34 healthy young women. Each was asked to give a speech about her candidacy for a job to two interviewers in white laboratory coats, who listened with stone-faced expressions, Zoccola said.

Half of the women were asked to contemplate their performance in the public speaking task, while the other half were asked to think about neutral images and activities, such as sailing ships or grocery store trips.

The researchers then drew blood samples, which showed that the levels of C-reactive protein were significantly higher in the subjects who were asked to dwell on the speech, Zoccola reported.
For these women, the levels of the inflammatory marker continued to rise for at least an hour after the speech. During the same time period, the marker returned to starting levels in the subjects who had been asked to focus on other thoughts, the researcher said.

The C-reactive protein is primarily produced by the liver as part of the immune system’s inflammatory response. It rises in response to traumas, injuries or infections in the body, Zoccola explained. “ More and more, chronic inflammation is being associated with various disorders and conditions,” Zoccola said. “The immune system plays an important role in various cardiovascular disorders, such as heart disease, as well as cancer, dementia and autoimmune diseases.”

Continuous Awareness During Bereavement


It is difficult to have a healthy relationship with food in this culture. We are invited to consume food of every kind by every media source on a 24-hour basis. The sale of cookbooks and gourmet items has sky rocketed in tandem with warnings about the health hazards of overeating and the nationwide crisis of obesity. A recent study raises the question of whether billboard Ads make people fat!

Many of us try to “ eat healthy” by adhering to a list of healthy foods only to find that the list keeps changing. Even more have stories of diets tried and failed–ranging from no carbs to no meats, to grapefruits, to eating by blood type.

While most of us love food, we often hate what we do with it or what it does to us. When you add personal histories, the plot thickens and the urge to give up and stay unconscious about what we are eating increases.

A Simple Step

In reality, while the goal to healthy eating is this culture is not easy–it is not impossible. Change of any type becomes more likely when we simplify the plan and make success possible. One simple first step is to recognize the roadblocks that sabotage most people’s efforts to eat less or to eat in a more healthy way. Once informed we are a step closer to motivation and mastery.

The Roadblocks:

Convenience
  • While the causes for overeating or eating problems are complex and personal, research finds that one factor that bears on most people’s eating is convenience.
  • Be it at home, at work, on a plane or at a wedding, if it is convenient– we are more likely to eat it.
  • In A Pew Research telephone survey most people reported convenience as their reason for eating junk food.
  • Food researcher, Brain Wansink found that the farther away a candy dish was from the secretaries’ desks, the less they ate– a difference reflected in 225 extra calories a day. In the debriefing, the secretaries revealed that the longer the distance, the more time to talk themselves out of eating another piece!
 A little inconvenience can reduce a lot of eating.

Visibility
  • You have probably heard comedians say they are on the “See Food” diet–eating everything they see.
  • In reality, they are correct.  Continuous research does reveals that visible foods trigger eating in a way that is difficult to resist. Neurochemically, the anticipation of food trips secretions that add to our craving and our overeating.
Hide the candy and put out the fruit in a glass bowl!

Multi-Tasking Equals Multi-Eating
  • In our continued attempt to multi-task, we pay a price-especially when it comes to eating. Because we eat in front of TV’s, computers, while texting, working at our desks and talking on the phone, we eat without focus.
One woman who frequently spoke on the phone while grabbing something to eat, reported that the trail of wrappers, crumbs and containers were often the only indication of her eating. She hardly remembered eating, much less feeling satisfied.
  • Anything that takes our focus off the food makes us more likely to overeat or eat poorly because we are eating in a mindless way.
The value of those advocating Mindful Eating, is an invitation to take the time for focus on food. Be it the shake you are having for breakfast or the twenty-minute lunch you purposely take away from technology, a routine to actually experience eating will be more filling and fueling.
Sleep Matters
The next time I am staring into the refrigerator at midnight, I need one of the milk cartons to say –”You don’t need to eat–You need to sleep.”
  • A frequently overlooked obstacle to healthy eating is lack of sleep.
  • A study measuring the brain activity of healthy, normal weight adults aged 22-26 found that a lack of sleep causes brain signaling to significantly increase in areas associated with food acquisition.
  • We need food to survive. When we are tired, our cells think we need more energy, which triggers a powerful subconscious urge to eat.
  • When we don’t sleep enough, cravings related to addiction and reward come in to play.
  • Even in children, lack of sleep is associated with weight gain.
Are you famished or fatigued?
  • Be mindful of your body states by deciding if you are really hungry or really tired.
  • Managing you sleep by aiming at 7-8 hours of sleep time will help regulate eating.
  • If you know you have gotten too little sleep or your sleep will be disrupted, be prepared to eat protein and high energy foods to stave off your hungry need for energy and catch up on sleep as soon as you can.
The Influence of Others
  • There is hardly a culture or a person that does not seek and savor the opportunity to share food with others. For most, it is central to their family and social connections. As such, it is understandable that both friends and family have an influence on our consumption norms and expectations.
 Consider breaking the family’s “ clean plate rule” or replacing the family’s use of ice cream as a stress reducer
  • Researchers found that having a friend who is gaining weight makes you 57% more likely to do so yourself.   According to both Professors Fowler and Christakis reporting on social contagion suggest that consciously or unconsciously, people use what others are eating as a gage for themselves-be it the oversized fries or the chocolate dessert.
The occasional evening of food and fun may be well worth having. Being swept into mindless overeating and overdrinking is physically and emotionally costly.
The more aware you are of your own body as a gage for what you want and need, the more present and secure you will feel as you enjoy sharing a meal with family and friends.
 
Recognizing the roadblocks to healthy eating is a step that may activate you motivation,  increase your mastery and improve your relationship with food.

Thursday, March 21, 2013

Five Steps



In the advent of multiple bereavements we all have difficulties of looking towards the “Light in the Tunnel.” Therefore, I have come up a few sources, which we all can work on with help from our Loved Ones, Bereavement Therapists and from contacting Dr. Nicholas at 877 867 8556.

Step One – Recognize your negative moments.  Admit to yourself you have negatively that can be curbed. How do you do that?
Step Two – When a negative thought crosses your mind, accept it, acknowledge it, and find a way to use the power of positive thinking to adjust your feelings.  Think of something positive about your life. Think of something you are thankful for and let that replace your bad thoughts.
Step Three – It is easy to let negative thinking result in complaining.  Whether big or small, before you open your mouth to make a complaint, stop.  You have control over your mouth, so don’t let your bad thoughts spill out onto your environment.
Step Four – Be mindful of people around you.  No one wants a complainer on their hands, and it only feeds more negativity to your life, and your environment.  It can isolate you from your peers when really you want to lean on your support group.  Respect your peers, and catch yourself before you open your mouth and say something unnecessary.  Find a positive thought and verbalize it.  Compliment your friends. You’ll find others being positively affected by your affirmation and, as a result, more positive energy will come your way.
Step Five – Optimism is a choice.  Know you have the power to turn a frown upside down.  You are in control of what you say so know that you have the power to make that attitude adjustment a reality

Thursday, March 14, 2013