A special thank you to Dr. Pam McDermott, our Psychosocial Support Volunteer who has agreed to
contribute these meaningful weekly messages
In these changing and uncertain times, it sometimes becomes challenging to
find a positive to focus on
This is particularly so as we have experienced many losses; loss of our regular rhythms and routines, social connections, and even the loss of a loved one
Grief & Holidays
Please visit our website page, Grief During the Holidays
TREES AS HEALERS
Probably you already know that being in nature helps us feel better, black flies aside. There is very interesting research about certain chemicals called phytoncides which are released by trees; they are antimicrobial essential oils which protect the trees from infections and pests and may boost the immune system in humans. If possible, walk, stand or sit amongst trees and allow yourself to wind down a bit. Even looking at trees from inside can be grounding and stabilizing.
THE PANDEMIC & MORAL DISTRESS
Moral distress occurs when what we are expected to do, or not do, conflicts with our own deeply held values and morals. There is much in the pandemic that puts us in this position; not being able to hug others when we or they need comfort, not being able to be with those we love, especially during this vulnerable isolating time; not being able to really see into another’s face in a connected way are just a few examples of moral distress. Intentionally looking for alternatives such as looking deeply into another’s eyes (an “eye hug”) is a start. “Bearing witness” by talking with, sitting with, praying or meditating for those we love who are suffering also reduces distress. Doing whatever we can within our control is empowering.
REGULATION
Being in a state of equanimity or stable self regulation is challenging when there is loss and uncertainty in our lives. In fact, there are times when it is appropriate to be “upregulated” (increase in alertness to attend to crises, say) or “down regulated” (lowering energy levels to rest, for example). Just being aware of one’s state is useful so we can act by recalibrating by lowering, or raising, our level of emotionality as befits the situation is a good start. We will always be making little course corrections.
GRIEF VS MOURNING
One way of thinking about the difference is that grief is ‘what we feel inside’ and mourning is ‘what we do outside that is visible to others’, such as ceremonies, rituals, gatherings etc. There are cultures where mourning is obvious and prolonged, such as wearing black for a year for example. Many of us in Canada cut short outward expressions of loss, with spoken or unspoken encouragement to “get on with it”. That doesn’t mean grief is gone however and premature shutting down of mourning can be harmful. With pandemic restrictions, we are in danger of missing opportunities for shared mourning altogether so we need to look for alternate ways to express our grief outwardly, such as crying with a friend, journaling, being in a Bereavement group here at hospice.
GRIT
In psychology, grit is a term used to describe a trait based on our perseverance of effort combined with passion for a particular goal or end state. Grit requires courage, conscientiousness, resilience, optimism, endurance and follow-through. It implies effort but not Hospice and palliative care staff, patients and families are exemplars of this trait.
BREATHING
In addition to providing oxygen and dispelling CO2, breathing regulates our nervous system. Breathing in and out in a controlled manner may help lower the stress response. Try any of these: 1) the Let Go method: take a slow breath, hunching up your shoulders and then suddenly drop them as you let the breath go; 2) Box Breathing: slowly breathe in for count of 4, rest for 4, out for 4 and rest for 4, 3) Resonant Breathing: breathing in a pattern in which the out breath is longer than the in breath, for example 4 in and 6 out. Do a few repetitions and then resume normal rhythms. Try this many times a day as you can.
FIGHT or FLIGHT vs TEND & BEFRIEND
While our initial response to a threat (real or theoretical) may be to fight against it or escape/avoid, (which can be adaptive of course), another response can be Tend and Befriend. This could mean reaching out to others to provide and get support, comfort care to self and to others, taking some sort of compassionate action; basically, it’s using that stress-associated energy to provide and seek out love. (May 31, 2021)
COMPLETING the STRESS CYCLE
While experiencing the stress response may seem to be a negative thing, it’s actually an adaptive response which we need to survive. The impact to our mental and physical health can be lessened if we complete the cycle. This means doing something to “exit the end of the tunnel”; it could be deep breathing, exercise, talking with a friend, being in nature, journaling, crying, pounding a pillow, hugging an animal companion, playing with a child, music and so on. These help physically metabolize and emotionally process the effects of the Stress Response.
THE SMALL THINGS
Mary Oliver, the poetess, recounts a story in her piece The Summer Day, of spending an idle day wandering in a field and dropping to her knees to watch a grasshopper eat sugar from her hand. She is, I think, addressing our modern tendency to be productive and busy at every moment. This is one of the hard things of serious illness, losing the ability to feel productive and useful. But isn’t being present to what is in front of us more important? The last lines speak to this: “Tell me, what else should I have done, doesn’t everything die at last and too soon? Tell me, what is it that you plan to do, with your one wild and precious life?”
SELF
Sometimes dying people have told me that they don’t know who they are without the scaffolding of working, being a partner, parent, club member – they’ve lost their sense of Self. Other people however, have said that with all of that stripped away they have come to feel like their true authentic selves, bare and raw and real. Both states of being can bring enlightenment if bravely encountered.
FEAR
When Fear knocks on your door, answer it. This might seem like bad advice particularly when facing serious illness or loss. Our instinct is to avoid fearful situations and sometimes this is prudent. However, fear will accompany all change and the best way to modify it enough that we can go on effectively is to acknowledge that fear is present. And then do the next right thing. It’s our ‘Fear of Fear’ that is most disabling.
GRAB LIFE BY THE HAND
Life is messy, joyful, heart-breaking and wondrous all at once. We do not have the choice to grab just the good things and leave the rest aside. Life will act upon us whether we want it to or not. The more we fully engage with all of it, all the ups and downs, the more alive we will be, even when we’re dying. That’s the paradox and the hope of the human condition.
FACING ONE’S MORTALITY
Whether someone close to us is dying, or it is us who’s at the end of life, we are faced “in real time” with the reality of death. Until we are actually there in that situation, death is only theoretical. Facing death is an immense and emotional task and we likely think we can’t handle it. Paul Kalanithi in his book When Breath Becomes Air quotes Samuel Beckett: “I can’t go on. I will go on”. It appears that both are true.
OUTCOMES
When we take on a task, or enter the medical system for example, we have an outcome in mind, usually a good one. However, if we get too invested in that outcome, we can easily become frustrated, discouraged or demoralized if the desired outcome is not forthcoming. Of course, we are aiming for beneficial outcomes and yet at the same time, not being too attached to a specific idea helps us adjust to change and impermanence. We still will retain hope, although the hope for a specific outcome will change.
COMFORT ZONE
We all operate within our own unique comfort zone, i.e. the space within which we feel most comfortable and safe. Our zone may be quite small or as wide as the world. It is wired into us to feel anxiety when we get to the edge of that zone; that’s what has kept us from falling over a cliff, literally and figuratively. However, the anxiety we feel when we get to that edge does not mean “Do not go further”; it just means, “Hey, pay attention, slow down and proceed cautiously”. Right now, we need to find that balance between safely proceeding and not allowing our comfort zones to be unnecessarily limiting
ADJUSTMENT
This is the process of adapting to new circumstances. The entire planet is undergoing the necessity to adjust to the novel circumstances of COVID-19. More personally, suffering a loss or anticipating one requires adjustment to this new norm. It takes a long time for something we know intellectually to begin to sift down into our being, to become a “felt experience”. Facing our sadness and loss and making small adaptations helps this process.
BEARING WITNESS
An (often desirable) instinct when we see suffering is to try and fix the problem. There are however, circumstances in which there is no fix. If we are close to someone who is critically ill and facing death, we are faced with the realization that we can’t change that fact. What we can do is bear witness, which simply means being with what is as it is happening. This might look like sitting with someone quietly at the bedside, or keeping them close in your heart or showing up in some manner as they live out their final days. This moment by moment acknowledgement of reality takes courage.
RESTORATION
‘Emotional Bank Account’ is a metaphor that can be used to think about maintenance of psychological well-being. Experiencing stressors and loss are ‘withdrawals’. Restorative activities such as being in nature, contemplative practices, meaningful social interactions are ‘deposits’. To avoid being ‘in the red’ it’s important to keep our deposits greater than our withdrawals. This requires making the daily intention to take care of our emotional solvency.
BEREAVEMENT
Bereavement is a process, not a task. This process is different for everyone and can’t be rushed. Nature is always giving me examples in its slow unfolding as it transforms from one state to the next. Watching tiny plants appear to struggle out of their seed casings, I know that if I “help” them to hurry this along I’ll only kill the plant. Grieve at your own pace and give others the space to do so.”
HELPING
Three types of ‘Helping’ are described and fall under the category of “prosocial behaviour” which loosely means “acting to benefit others”. When we are wanting to be of help to others it’s useful to consider what type of help will serve in each situation. General ‘helping’ involves meeting a physical need such as making a meal, driving to an appointment etc. ‘Sharing’ is meeting a material need such as a charitable donation of money or sharing extra garden produce. ‘Comforting’ is the third type and involves providing solace and a quiet presence to those who suffer. Giving help in appropriate ways, AND being able to receive is one of defining characteristics of being human.
ANXIETY
Here is a good definition of anxiety: “Anxiety is fear surrounded by a story”. This refers to our tendency to first experience a threat or fear and then create a story around it, to try and make sense of what’s happening. The mind will scout around and look for anything to account for the feeling. However, this actually serves to amplify the anxiety. The more we can leave out the story and just say, “well, there’s fear”, the quicker fear will dissipate
GRIEF
Joan Sutherland says “Grief is how we love in the face of loss”. The only way we can avoid grief is to never make a loving connection with anyone or anything. In fact, grief tells us we have taken the risks to fully embrace life.
VITAMINS
We all know that Vitamin D (which we get from the sun) is beneficial for us. An equally important Vitamin is ‘Vitamin Awe’. Cultivate a sense of wonder at life around you, whether it be in nature or in our connections with each other and our animals. Even in the midst of sadness and despair it is there as solace.
OUR FEARS
You’ve no doubt heard of the Fight, Flight or Fear response to threats. There is a fourth: Face. Paradoxically, learning to face, and to be with, our fears actually can reduce them. We can learn effective ways to handle what scares us, to face life in all it’s complexity. We all have wisdom and resilience within us, in greater measure than we realize.
INTERCONNECTION
Indra’s Net is a myth which holds meaning for us. Imagine a vast net reaching into infinity and every connecting node in the net is a jewel. Each jewel represents an individual, a cell, an atom. A change in one jewel no matter how small means a change in all the connecting jewels and outwards from there across the whole net. What I do affects everyone else. We are all interdependent; what each of us does, matters.
DIFFERENCE BETWEEN COMPASSION AND EMPATHY
To avoid burnout and empathic distress it is important to learn the difference. Empathy means being able to put ourselves in someone else’s shoes and viscerally feeling what they are experiencing; while this is an important trait, unchecked it can lead to over-identification of someone else’s suffering and inaction. Compassion means suffering along side of, shoulder to shoulder, and bearing witness while remaining grounded, not taking on the suffering oneself, and being able to move towards taking appropriate action. We can run out of empathy, but not compassion.
RESILIENCE
Resilience doesn’t mean one doesn’t suffer or ever fall down in despair. It means the ability to rebound, to get up from the ground and to remember to call upon the strength and wisdom that is already inside of you. The qualities that result in resilience include patience, acceptance of reality, letting go of outcomes, faith in one’s inner competence, living in the present, flexibility, surrounding oneself with resilient people, and taking the next steps.
BOTH/AND…
It isn’t helpful to think dualistically; good/bad, happy/sad etc. Things are never just one way although it can seem so when there’s a lot of emotion or troubles. A non- dualistic approach can be healing and hopeful. “I am both deeply sad and grieving AND I am grateful for the time I had with my loved one” is an example of non-dualistic way of thinking
SETTING INTENTIONS
When sadness and anxiety swirl around us, setting intentions can help ground us. When you wake up, set an intention for the day. Be as specific as possible. It might be that you are going to treat yourself with gentleness, or purposely look for sources of joy in your life, or bring some structure to your days. Put a Post-it note where you’ll see it. Then check in with yourself (kindly) from time to time during, and at the end of the day, about how you did.
WHEN OVERWHELMED
When troubles surround us, we can feel overwhelmed. This is completely normal. Here’s an idea to get back on track. There’s an AA saying that when you’re in the state of feeling overwhelmed, just do the next right thing. This might be doing the dishes, or even washing one dish; make a meal; take out the recycling. Many “next right things” will add up and life will feel more settled.
LIVING WITH UNCERTAINTY
It is human nature to live with the illusion that we have control over our lives. When we have a loss, or there is chaos around us, we feel unmoored. In reality life is always uncertain and circumstances impermanent. The more we learn to surrender to this reality, the more we can ride the waves of the ever-changing life we’re in.
SORROW and TEARS
When facing significant loss, we can feel like we’ll never stop crying. Or we might be holding back tears because we were taught not to show emotion. As far as is known, only humans have tears specific for emotional expression; tears of grief and joy are a different chemical composition containing more stress chemicals. Shedding tears plays an important biologic response in balancing stress hormone levels. Allow yourself to cry.
GRATITUDE
When suffering, it’s challenging to feel grateful for anything. This is because the mind is programed to focus on what is wrong, rather than what is right. We can override this by intentionally thinking of a few things each day to be grateful for; it is especially beneficial to write them down. They might be very small things like seeing signs of spring, or the love of an animal companion, or bigger things such as our health care system, supportive friends.
LOVING KINDNESS To ONESELF
Love isn’t a pie that has limited slices and is all gone; it’s more like sourdough bread that keeps expanding. Here’s a morning exercise to help if you wake feeling worried, lonely and sad. As soon as you awaken, put your hand over your heart and say, “Good morning (and say your name), I love you.” This releases oxytocin and can set the tone for the day. You can expand this to include your loved ones, the community and the world.
HOPE
It may seem there isn’t much room for hope with what is happening in the world as well as perhaps in your own lives as you face loss or potential loss. Well, there is always hope to be had. We may need to keep changing what we hope for as circumstances change. It might even come down to hoping for a sunny day, or less pain, or a moment without overwhelming sorrow. Never give up hope; it is the antidote to despair.
