Nursing Notes

December 2, 2011

More on Grief and Loss

Filed under: Uncategorized — Shirley @ 9:08 pm

As I am personally experiencing some of both, I found this article to be helpful.  I hope to get another guest posting but the author after the holiday season is over, but for now I will post this article she sent me.  I recommend her book and hope you will visit her website for more information about her.

I would like to invite other nurses to guest post here on this blog.  I try to make this blog a place to come and find viable and current information that reflects on the nursing profession as a whole, but most importantly, on the nurse at the bedside.  Any information that I can produce to empower that nurse, to educate that nurse, to give that nurse a voice is what I aim for here on this blog.  If your writings fall into that catagory, I would love to have you guest post.

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   LOSS, GRIEF AND THE WORK-0F-GRIEF: A DIFFERENT PERSPECTIVE

                                                                              By A. Barbara Coyne, Ph.D, MSN

 

Loss: Ever-Present in Living

 

“The hour that gives us life begins to take it away”…Seneca, first century philosopher

In the unfolding spiral of living, loss is inevitable and universal. If we heed the wisdom of Seneca, we know that we experience loss from the moment of birth until our own death. And throughout the subsequent twenty centuries, we have known that grief is the natural companion of all loss. Although much of what we know about grief is rooted in post-death grief, we also know that we experience other losses: we are connected to people, animals and things and when any of those connections break, we grieve and mourn. Some of these “other losses” include but are not limited to: loss of a job or home, friends who move away or choose to no longer be our friends, chronic but not life-threatening health conditions, divorce, separation and, of course, death (of people or beloved animals).

 

Every loss leaves an indelible print on the very core of one’s being and each becomes an integral aspect of the unfolding biography that makes you uniquely you. It is this uniqueness of each grief story that renders meaningless the well-intentioned cliché: “I know just how you feel because I’ve been there”. No one experiences your grief in your way. While there are identifiable commonalities in how grief shows itself, each individual’s experience of grief is unique in light of the meaning, context, and current circumstances in which the loss is embedded. Every loss, then, becomes a part of the historical context in which a loss in the present is experienced and expressed. It is in this sense that grief is over…but it’s never over: it changes over time as we learn the lessons that grief, our internal healer, teaches.

 

Grief: The Internal Healer

 

 Look well into thyself, there is a source of strength which will always spring up if thou wilt always look there.”…Marcus Aurelius, Stoic Philosopher and Emperor of Rome (161-180 A.D.)   

     Grief, the natural response to all loss, is a fundamental aspect of our humanness. It represents a vital energy within the healing life force, the creative power in all of us that propels our on-going shifting, changing growth. We can think about this vital energy as the “wisdom of the body”—a very old concept having to do with the body’s power to heal itself. This idea has changed over time, stretching from the ancient temples of Asclepius, god of healing, to the modern versions of “stress theory” in the medical model. But it is in the ancient sense of a healing life force of the whole person—not the modern construction of “body-mind-spirit” or “bio-psycho-social parts”—that grief can be recognized as our internal healer.

 

In this perspective of grief as internal healer, we recognize that grief is not a sickness from which we “recover” in a prescribed timeframe through the well-known five stages: it is the very essence of the human condition in whose wake we learn to live. The learning surfaces as we willingly, albeit reluctantly, engage the difficult process of the work-of-grief…not to be confused with the psychoanalytic concept of “working through issues”.  It is a process that sends us deep inside to wander through the depths of our pain, honor the truth of what we find as we seek the “strength which will always spring up if thou wilt always look there”.

 

The Process of the Work-of-Grief: Discovering and Creating New Meanings

        The Essence and the Elements of the Process

v    The Essence:

           “Adopt the pace of nature—her secret is patience”….Ralph Waldo Emerson

 

The very essence of the work-of-grief has to do with using energy to heal the pain of loss as we struggle to discover and create different meanings in a world that seems suddenly chaotic and meaningless. All life processes require energy: from the fundamental basics of cellular function to the increasingly complex human engagement with living, we use vital energy and constantly revitalize it in a variety of ways. Since all losses are embedded within the on-going process of living, when we experience a loss, grief—that internal healer—alerts us that we are now using even more of that vital energy. It explains why one of the “identifiable commonalities” in the experience of grief is an unremitting and overwhelming fatigue. It is this further depletion of vital energy that can contribute to making us sick. Respect this “wisdom of the body”: it is telling us to gentle down, slow our pace, attend to the myriad messages coming from within, nurture our patience and carefully nourish our “self” as we embrace the difficult process of the work-of-grief. It is a time to “adopt the pace of nature”, whose secret is “patience”—to help us tolerate the pain of loss as we inexorably move toward relinquishing our grief through actively embracing the elements of the work-of-grief.

 

v    The Elements: (three simultaneously unfolding elements)

               “The only way out of the desert is through it”……An African aphorism      

 

  • DISCONNECTING-CONNECTING which has to do with disconnecting from the familiar rhythm lived with the person/thing lost and at the same time, connecting with the unfamiliar pattern your life is now taking. This creates a profound struggle as you try to “understand” and “make sense” of your loss—as you

 

  • NARROW THE KNOWING-BELIEVING GAP . “Understanding” has to do with knowing and believing, two different ways of interpreting our world: knowing has to do with “facts” before us; believing has to do with coming to know these facts from our inner experience of them. There is often a wide gap between these two ways: it’s why a common expression following a loss is some variation of “I can’t believe it”—even though you know it: you saw him in the casket, touched him and knew he didn’t feel alive; you hold the divorce  papers in your hands; your friend has moved across the country so you don’t see her every day, your beloved cat does not greet you at the door—so yes, you know it, but you do not believe it: yet! And no, this is not the psychiatric mechanism of the stage of “denial”. It is the “wisdom of the body” offering you a slowing of the process as you come eventually to narrow the gap between what you know and what you believe. You come to this understanding in myriad ways as you live the reality of your changing pattern of living.  FOR EXAMPLE, EACH TIME YOU:

 

  • reach for the telephone to call your mother for your “daily 3:00 call…..
  • wander through your “empty house’ in the after shock of your spouse’s “moving out”….
  • see the dog’s empty dishes…
  • wonder why and how this could have happened….
  • question how or what you could or should have done better/different/sooner/not at all……….you are narrowing the gap!

Many similarities cross the spectrum of loss—whether related to death, divorce or separation; whether from person, animal or thing. But there is at least one significant difference: for those grieving a loss through death, the reality becomes more concrete in light of the absolute finality of death; for separations or divorce, the person is still “out there” and while communication may be changed or non existent, thoughts of “what if” persist over time. It is important to let all this confusion and disorientation tumble through you as you grieve and mourn your loss…..inexorably you

 

  • RESOLVE THE WORK-OF-GRIEF which has to do with becoming more familiar with your changed living pattern. Grief, your internal healer, has guided you through this very painful process, to a higher order of wholeness as you integrated new awareness, explored  some difficult truths about connections, relationships and ways you participated in the rhythm of their unfolding. You tolerated the discomfort of engaging the truth presented in your questions and doubts.  In search of peace and perhaps serenity, some choose not to engage their truths because the risk of “seeing” may be greater than the risk of “not seeing” and yet, profound growth surfaces in our willingness to honor our truths, no matter how painful or incongruous. The theologian, Reinhold Niebuhr said it this way: “The final wisdom of life requires not the annulment of incongruity but the achievement of serenity within and above it.” You have lived the incongruity and found your way “out of the desert of your grief”.

 

     And finally…grief always offers us the opportunity to grow in light of the many losses throughout living. We embrace this growth when we acknowledge the transitory nature of life, hold firm our beliefs and values, honor the truth of our participation in the world and focus on the gifts we have to give. With Hemingway, who tells us (A Farewell to Arms) that “the world breaks everyone, and afterward many are strong at the broken places”, we embrace the strength at our broken places—and we create different ways to be happy.

 

This perspective can be further explored in my recently published book: You Don’t Have to Like It, But You Do Have to Live It (Visit me at www.barbaracoyne.com )

 

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