Rachel Pauli: Welcome to today's webinar! Feeling Sad? Move Forward After Loss.
My name is Rachel Pauli and I'll be the host for today's webinar. Please remember to get a copy of the PowerPoint as well as the tip sheet under the event resources section. If you have any questions you can submit those through the "Ask a Question" box. Our presenter today is Kris Hooks. Kris is a licensed professional counselor, a marriage and family therapist, a certified employee assistance professional and a certified wellness coach. Kris has provided and managed employees in behavioral health field for over 30 years. She has written and facilitated seminars and webinars for hundreds of organizations and many fortune 500 companies. So without further delay, Kris, I'll turn things over to you.
Kris Hooks: Rachel, thank you very much. And I really just commend you that you would take time out of your schedule to focus on something that's not very easy to talk about. This is a topic that puts you face-to-face with things that are really hard in life. The longer we live, the more opportunity we have, many times to experience grief and loss. It's really important that you understand that grief is normal. There is a process that we go through, there're things that you can do that will help you and also things you can do to help people you care about.
So, specifically, in today's webinar, the learning objectives we'll cover, we're going to talk in more detail about what grief is. I'm going to help you really think about your lives kind of in a big picture package, all the life events that might trigger grief and loss.
To talk about the stages of grief that are again are very normal. We'll define that in a way where you'll better understand not every stage is gone through in the same way by the same person even if the loss is the same and with different losses we may experience different stages in different ways. Again, we'll go into detail about that to help you identify the signs, the red flags of when you or somebody you care about really might need some extra help or support and I’ll just say it upfront and I’ll say it on the backend too and I'm probably say it in the middle, EAP is there to help you.
EAP is a benefit available to you when the hardest of things in life happen, not only you but eligible members too. So, I really like it that we will end with what helps, what helps you cope, and as a mental health professional I'll definitely talk about what doesn’t help; we call those counterproductive coping strategies and we don't want to fall into those traps, we want to do things that help us move forward in our life, just as our title said.
All right, with that, we are going to dive into what is grief. So, I want you to just look at this definition. Grief is the normal reaction of responding to loss, any kind of loss in life. It is the emotional suffering that’s involved when we are separated from someone or something that is important to us.
All right, things I want you want to really take with you from this slide. Normal, I know I keep saying that, we need to recognize it because that helps us know we shouldn't try to sweep grief under the rug or self-medicate it to numb it, we need to walk through it so we can get to a better place.
The changes that we experience cause an emotional reaction. Again, an event happens, that's what triggers the grief, but walking through that, that is a process overtime, learning how to live with loss, put life together after loss takes place, that’s not easy for us as individuals.
So, let's look at "Life Events That Trigger Loss". I'm telling you this laundry list is long and if we go through it, I want you to think about yourself; what you've been through in your life, you can think about people near and dear to you and what they've been through in their lives. This can be friends, family members, co-workers, that top one, "Loss of a job", I always in my life thought if you work really hard, you will have job security. Well, that little belief got rocked about 2 years ago, when a job that I had that I loved, fell victim to the price of oil in that wonderful job that I thought I would have for 10 years went away as in the job was downsized and that meant I got laid off.
There is a sense of identity and purpose that many of us have with our work that when that removed, that can really be difficult. I always knew that but when I walked through it personally, I felt it in a different way. What about re-work when you get a new boss, you know different co-workers, mergers, acquisitions; just it’s there's looming change in your industry and there's uncertainty that can certainly be a stress reaction.
Retirement, a different phase of life, a new chapter, even when you know that's coming it really depends on your ability to prepare for it and embrace it, how well you do? If in your industry they're offering at times, things like early retirement packages, that can be difficult. Retirement brings about those changes where we change what we do on a daily basis, and who we're hanging out with and that can be difficult.
Well, all right, aging, "Hey, I'm an expert on this one. I don't know, I will tell you it’s when I am 58" so the longer we live, the more we realize things happen as we move along chronologically with birthdays. This girl, me, I am never running another half marathon. I do not have knees that are able to do that, really even a 10k according to my orthopedic is not a great idea. And the words out of his mouth were, "I wouldn't run, if I were you." That's not easy and again that's a very small thing in life but age can cause changes where we miss something that we used to be able to do or if aging causes loss of loved ones, that can be incredibly difficult.
Personal injury illness that can be our own or people near and dear to us, typically death is someone that we think of "that's the big one," loss of loved ones, pets, the end of a relationship, those are our "big in life".
Any kind of changes that we go through whether those changes are at work or you know outside of work; think about, if you have children the changes that kids go through in the way that parents experience those too, whether it's a child starting preschool or kindergarten transitioning, elementary school to junior high or junior high to high school or high school on to what's next in their life or moving; any kind of change in our life actually can trigger loss.
What about trauma, things like natural disasters, or a traumatic accident, awful things, assault, burglary, any kind of violence, any kind of abuse definitely that triggers huge losses and stress in our lives, yeah I keep believing how am I mentioned? Before we look at the stages of grief, I just want to stop for a minute and as you're looking at these life events, I want you to think about what might make grief more intense.
If somebody experiences a lot of losses close together or they have one of those very sudden unexpected traumatic losses, I mean if that's a loss of someone younger, that is many times one of the worst losses in life, it's unexpected. I think of all the people I've ever worked with through counseling, loss of a child has to be the absolute worst. Even if you know that someone has a terminal illness, like stage 4 of cancer, they're under hospice care, or they've got the onset of dementia or Alzheimer's, there's a series of losses that occur overtime and in a lot of times the uncertainty can trigger anxiety and additional stress so again as you think about yourself and people you care about, just keep those things in mind.
Let's look now at "Stages if Grief". So, this is based on Elisabeth Kubler-Ross. She wrote a book on deaths and dying, these 5 stages have been around well since I entered the mental health field over 30 years ago. This is what I want you to know as a backdrop as we talk about these stages. Grieving is not a linear process.
It's not like, "Oh okay, well I'll do it two weeks in denial and then I'll move to anger, I'll do that for 3 weeks and then I'm…" It's not like that at all. We can actually, it's a fluid process. We can wave forward, wave back, we can be in more than one stage at a time. The stages don't have to be in this sequential order. We kind of trend through these where there is a downturn and then there's an upturn even if we reached the place of doing an upturn and putting life together where it's working better for us.
Anniversary reaction is like the first. If it's loss of a loved one and it's their birthday or it's one of your parents and it's mother's day or father's day or there's something in the environment that just triggers memories of that person or for sometimes just nothing happens, something just waves over us out of nowhere. Those things can cause us to move very quickly in terms of our emotional reaction.
So, let's just look quickly at these stages. So denial certainly, initially, especially, if it’s an unexpected traumatic loss, there can be this sense of in shock, we just don't believe that what has been told to us has really happened, it's just hard to take that in. Over time reality hits, we may be angry, we might blame ourselves, blame other people, be bitter, resentful, lash out or turn that anger inward.
Anger is sometimes an easy or easier emotion to go to especially for men and again, it's not recommended that we get stuck in anger, I call anger sometimes as second layer emotion, where if you peel it back there is something underneath there besides anger. So again, with grief we need to do that.
Bargaining is where we dig a little deeper. You start trying to kind of figure things out, the reality really sets in. What could I have done? You start trying to make sense, sadness, and depression can come, very low energy, difficulty with sleeping, eating, concentration, just daily functioning. If a person is genetically prone to clinical depression, there maybe triggering event, a loss that can cause a person to really dive into clinical depression, same with anxiety that may need additional treatment.
Acceptance; isn't this the place? Like it's so easy to just say that word and sometimes it's so hard to get there. I remember one really good friend, her husband died pretty suddenly and she said, "I hate it when people say this is your new normal," but this is not normal. In reality, we just have to find a way, and a place, and a time to put life together where we can function.
What might make someone vulnerable to getting stuck in this downturn where things just whirl around? Think about it, if the person has really restricted coping strategy, if they're having tremendous stress outside of the loss that they just got pounded with. If they're having health problems, physical health or mental health issues, if there's any addiction or any other stuff I talked about, clinical depression or anxiety, that can make it much harder for someone.
I want to look at some of the common symptoms of grief. And you'll see, some of these parallel with what we just talked about. There are just so many emotions that are common in a grief reaction. I talked about “in denial” again. People who self-medicate sometimes stay in that place where reality doesn't hit, that is not recommended, that numbing behavior actually only makes things worse.
Sadness and depression, of course, you can understand that. It's a very important part of grief that we save these negative emotions, that we acknowledge the losses, that we're able to put into words whether that's words to someone else or writing them down how difficult this is.
We may have tremendous guilt, I always think, of all the people I have worked with and situations I have been through in my own life; suicide is the worst. People who lose someone to suicide go back to what have I said, what I have done, how could I have known and the guilt that they may feel may be tremendous. Even outside of suicide, if there are unresolved relationship issues, if there was conflict, right before someone's unexpected passing, that can be awful because you go back to what you wish you could have better done when they were still living.
Anger, again understandable self or others. Fear and anxiety, a lot of times people are how am going to be able to go on? Fatigue and that can be caused by lack of sleep. Insomnia is very common. Changes in appetite and weight and again, people who lose their appetite and lose weight, those are I know fewer of them, I know more people who tend to do comfort eating of less healthy food and weight goes up and sometimes it depends on kind of where you are in the stages of grief, how your appetite and your sleep are affected.
What’s really important is that you be very, very attentive to what your symptoms are and to what the symptoms are of the people around you. If there are some red flag symptoms, if it seems like someone's stuck or their grief is complicated, that's the sign they need additional help and support.
So, let's talk about what is complicated grief. If someone feels like life is not worth living, if they have lost someone near and dear to them and they have strong thoughts and feelings about I just want to join this person, and if that means I need to in my own life to do that and considering that, now, I'm not saying just because that thought would cross someone's mind it's necessarily a huge red flag.
Many times in the throes of grief, it depends on your spiritual belief what you think happens after death; if a person misses that other person so badly they may think about what it's going to be like to be with them again. That's not the red flag we are talking about. What we're talking about is somebody who is actively saying, "I just want to die, I'm thinking about ending my own life or I have a plan." This is what I know about suicide prevention. We always take those kinds of comments, any kind of behaviors that are of concern seriously, we talk to the person and get an immediate help for them.
Sometimes, people think talking about it is going to make it worse for that person, nothing could be further from the truth. Bring it out in the open, that's the right thing to do. If someone is just preoccupied, they just can't think of anything.
How people cope varies. I've worked with lots of people who have lost loved ones and I have had that happen in my own life personally, how you handle their belongings and cleaning things out? Some people do that really quickly after a loss. Other people are like, "I don't want to change anything, I want clothes in the closet, I want their things, I want everything the same, that's comforting to me."
A red flag would be it's a year later and nothing's moved out of place. All the clothes, everything's exactly as it was. That's a sign of an inability to move forward. Denial of the loss absolutely and again I mentioned substances; things like alcohol or abuse of prescription medication even abuse of over-the-counter medications, illegal drugs, those can keep a person stuck in a very bad place and then use of those substances actually affects the person additionally negatively. So again, that's one of those counterproductive coping strategy, you don't really want to be hanging out there.
All right, what about people who just get so bitter and so angry and so resentful that everything about them changes, again, huge red flag. What if someone just avoids anything and everything that reminds them of that loved one. They won't go to places they went to together. They are just trying to protect their emotions and numb them. Again, we would want them to know you've got to walk through the process of grief to get to a better place.
All right, there's the bullet, self-destructive behaviors, we talk drugs and alcohol, what about stuff we can do online, what about too much online shopping, or what about gambling online or in a casino or, what about sex addiction, or overeating, videogames, the list could go on and on. Anything that numbs us temporarily, if we do that too much, we're going to end up stuck in that place, especially, if we have addictive genes. So again, beware that's a huge red flag.
What about lack of ability to trust other people? In the process someone thinks the world is not safe place now, they build up big tall walls, they feel numb or disconnected, more than and again these are common, that is common in the beginning, but six months out, you don't want to be in that same place. You want to be trending favorably over time.
Feeling like there is no reason to go on living. Life has no meaning, no purpose, again initially, that can be very understandable. As time goes on, you don’t want that sticking on a person. Blaming yourself for the loss or failing to be able to prevent it, I might also add, if you just feel stuck, you feel like you are not getting traction, you know what to do but you're having trouble getting there. That's a big red flag and again I'll do more about the EAP, but EAP can totally help you. If you hear having these signs or someone near and dear to you is, EAP is expert at helping people get unstuck when they're in the throes of grief.
So, what are some tips to help you with grief? Look at that first one there, no surprise there. You've got to face your feelings and allow yourself to go through the process of grieving. Again not easy, when we do try to sweep grief away, this is what I call it, it comes out sideways. Our physical health and our mental health will suffer, our relationship will suffer, our work, our productivity will suffer. We'll just struggle in life and we'll be a lot more prone to negative things so acknowledge what you're feeling, second bullet find the ways to express those feelings that work for you.
Tangible creative ways certainly, there are many people who enjoy talking. Some people would rather talk less. You find what works for you and counselor I believe that I know they are talking out. If you're a person who would rather write, you can get a journal. Write and mail letter. Write the things that are bothering you, that you wish you could change. I think from that writing to process, that was a mental health professional makes a lot of sense.
Get in a support group, use art to draw, paint, sew, quilt, do wood working. Any way that you like to express yourself that you enjoy can be healing, dancing, movement, physical activities, find ways. Get it out. Don't hold it in.
Take care of your physical health. Make sure you're sleeping and you're eating and you're moving around. If you don't like the word exercise, just go for a walk. But yeah, you do things that are good for you. Make sure you work on forgiveness. This talks about forgiving yourself, letting go of any regrets. Forgive other people too. Things you wish they had said or done. Things you wish you would have said or done. Forgiveness is a gift as much for yourself as for the person you're forgiving so we have to work on that. And it's a choice, it's not an emotional reaction, you don't have to feel like forgiving someone to actually forgive them.
Another tip for coping, try not to pile on extra stress. If you can set up life where additional stress, you're a little removed from that, that would be recommended. Again, that's not always possible It depends on your life and how that works but definitely take care of yourself. They say no major decisions okay. After divorcee or death of the spouse or rebound romance is not really recommended so when you're in house or moving the next day not really recommended, you’ve got to take time to process. And get solid information, use your resources, make those decisions over time.
Support; friends, family members, support group, and there are specific support groups geared for people who are grieving. Compassionate friends is there for people who have lost children. If someone has a miscarriage, there are support groups to help couples going through that. Survivors of suicide, there are support groups through hospice care. It depends on your religious beliefs if they are members of the clergy, they are trained to help people with hard things in life as our mental health professionals.
Grief can be awful -- lasting. You might need to take a break from grief. What this means is give yourself permission to smile, or laugh or do something you enjoy. I know in my work with people who are counseling they will be like why we shouldn’t be able to smile. It seems like I’m not honoring the magnitude of the loss. If I have moments of happiness or even joy in my life, nothing could be further from the truth. We need to find ways to have other emotions too.
Plan for grief triggers; as I mentioned all the first. The first holidays without a loved one. The first birthday, their birthday, your birthday, any important event on the calendar can trigger grief. Think ahead about how you want to celebrate or honor that person. Some people set a place at the table on a holiday for the person who is not there. I was at a wedding recently where the bride’s brother who died in an accident now about seven years ago very traumatic, very sad, one of the bride’s maid came down the aisle alone and in the program it was clear that, that was in honor of the bride’s brother that made me cry, that was a very special wedding.
So again, talk to people, figure out, some people plant trees, or got to a favorite restaurant, they light a candle, there are so many ways but explore how to do that. What about just taking a deep breath and be impatient with yourself. Remember this healing process takes time. You want to be doing things to help yourself along, but there is no like I should be finished with this grief in this amount of time, it just does not work that way.
Kind of related to when I was talking about planning for grief triggers, develop rituals to keep the memory of the person alive, have a special meal in honor of them, have something that reminds you of them that for you helps bring comfort. Again, that’s very individual. It depends on the person, talk to the people near and if the loss impacted more than just you and work on that together. It’s a normal experience to life’s losses --