The Healing Power of Love in Grief

The way we grieve is a result of what we learned about love and relationships as a baby. We all learned certain “rules” growing up about love, such as “don’t give your heart away” or “don’t love too fully or you’ll get hurt.”

Through my work as a grief counselor, I have come to believe that the grief process is akin to the process a young child goes through in separating from his or her primary caregiver (PCG). For the first few months of life, the infant experiences no separation from the PCG – they are one and the same. Little by little, the developing child comes to understand that he or she and the PCG are in fact separate beings. The child starts to experiment by crawling or walking away from the PCG, coming back as necessary for “emotional refueling.” Playing peek-a-boo games teaches the toddler that even though something may be physically hidden from view, it still exists. Around the age of three, the child is able to understand the more abstract notion that he or she can keep a representation of the PCG, in his or her heart, and with that emotional presence and support, can venture out further into the world without the PCG. The development of this capacity is called object constancy, i.e., “a coherent mental representation of important attachment figures.” (Worden, 1996, pp. 9-10, citing Bowlby (1963, 1980) and R. Furman (1964)).

The inability to retain a sense of object constancy, and to remember that the PCG is a resource even when she or he is not physically present leads to many difficulties in forming healthy relationships and good boundaries. For example, those with borderline personality disorder or other attachment disorders were unable to achieve the capacity for object constancy because the mother or other primary caregiver was neglectful or abusive, physically and/or emotionally and did not therefore create a sense of safety and trust in the growing child.

Grief theorist J. William Worden (2002) describes certain tasks a bereaved individual to complete in order to navigate the grief process in a healthy way. The first task is to accept the finality of one’s loss; the second task involves feeling, and not avoiding, the pain of one’s grief; the third task is to adjust to an environment without the deceased; and the fourth task is to “emotionally relocate” the deceased and move forward in life. This process of “emotionally relocating” the deceased loved one is akin to the development of object constancy.

This process of grief and love was illustrated in a poignant way with one of my grief therapy clients, who I will call “Joe” for the sake of confidentiality. Joe came to see me for therapy after the death of his young wife, “Jody” as it became clear that his suffering in his grief was unrelenting. A common theme in Joe’s lamentations was that his wife was quite mean to him, especially as her cancer progressed and affected her brain. Joe was unable to talk about Jody without crying, and he developed some unhealthy coping tools to assuage his pain. As the first anniversary of Jody’s death drew closer, Joe’s suffering increased.

I recently asked Joe if he loved Jody, and with tears streaming down his face, Joe for the first time in our sessions said that he loved his wife. It felt as if a dam Joe had built around his heart had burst, and he was able to open his heart to his love for Jody. This was truly a breakthrough in Joe’s path to healing his grief.

It was clear that Joe needed to find a place for the Jody he loved in his heart in order to move forward in life. For so many of us, like Joe, this is a process of having the courage to love wholeheartedly. Many of us hold back pieces of our love out of fear that doing so will make us too vulnerable. However, vulnerability is not a weakness and does not put us at risk of harm. Rather, the word “vulnerable” simply means the ability to be open. Being open allows us to see things more panoramically and makes us stronger, not weaker. More importantly, being open to loving fully allows us to keep our loved ones with us as a source of strength and support when they are not there in person.

Loving and living fully after loss often entails completing “unfinished business” with our loved one in some way, whether through therapy, journaling or other expressive means. We may need to forgive our loved ones for their human weaknesses, and also forgive ourselves for difficulties in the relationship. No relationship is perfect, and letting go of resentments, guilt or fear is an important piece of the process of finding an open place in our hearts for our loved ones who have passed. Only then can we relocate the deceased emotionally in our hearts, heal our grief and move forward in life.

WHAT MY CAT HAS TAUGHT ME ABOUT AGING AND DEMENTIA

My 16 year-old cat Andy has been showing the signs of dementia for the last year or so. Her symptoms worsened since the death of her beloved kitty playmate Lucy six months ago. Working with dementia patients in hospice, I have known on some level what helps in caring for them. Andy has been my personal teacher, helping me deepen my understanding of the needs of individuals with dementia, and I have learned so much from her on an emotional and heart level.

1. The need for safety.
Like children, dementia patients need to feel safe and secure in navigating their world. Andy has always been a “talker” – she may be part Siamese with her pretty blue eyes. However, her quiet meows have morphed into loud yowls. She sometimes seems to be in a panic. Talking to her in a soothing tone is helpful.

Andy has her own fleecy bed, which we bought for her after Lucy’s death. She seems to feel more secure when she is in it. The soft texture and rounded walls of her bed really seem to bring her comfort. In contrast, when she roams freely around the house, she appears lost, anxious and confused. This affirms for me that smaller rooms with familiar objects are most helpful for all with dementia.

2. The need for food, touch and motion.
I learned in my Human Development psychology class that what infants need most is food, touch and motion. That’s why we feed babies on a schedule, give them lots of affection, and rock them to calm them and help them sleep. The same applies to elders with dementia – including Andy. She asks for food like clockwork every two hours. So, we feed her on that schedule. Food is definitely comforting to Andy, and I believe the consistency of the schedule helps her too.

It goes without saying that we all need touch – Andy certainly does too. As to motion, I recently learned that picking Andy up and rocking her like a baby really helps soothe her when she is anxious. Similarly, we often see repetitive rocking motions in our hospice patients with dementia, demonstrating that rocking is an innate self-soothing response.

3. The need for caregivers to set boundaries and take care of themselves.
For a while, my husband and I followed the every two hour feeding schedule around the clock. However, we recently stopped doing this because we were becoming dangerously sleep deprived. Andy would be relentless at all hours of the day and night in her quest to be fed. It was difficult for me to stop giving in to Andy, and even more difficult to confine her to one area of our home during sleep hours. Having let go of my resistance to setting this boundary, I must say that it has been a huge help in keeping my husband and me healthy and less stressed out.

Self-care is vital for caregivers. I often remind my caregiver clients, both in my hospice job and in my psychotherapy practice, that if they don’t take care of themselves, they won’t be able to take care of others. It’s crucial to take breaks, set boundaries and get support. As they say in the safety announcement on airplanes, put your own oxygen mask on first before attending to others.

4.   The need to acknowledge grief and loss.
After witnessing my cats’ reactions to the death of their buddies, I am clear that animals experience grief. Andy’s grief is expressed in searching behaviors, seeking Lucy in the places where she would hang out before her death. Likewise, people with dementia experience grief and loss. Like young children, they may not be able to express their grief on a verbal level, but they definitely feel that someone important is missing in their lives. In caring for the bereaved with dementia, it is important to validate their feelings of loss and provide comfort and safety.

5. The need for validation, dignity and respect.
The need for validation, dignity and respect is universal. There is a tendency to treat the old and infirm like helpless beings who no longer have any worth. That is a mistake. We all want to remain independent and in control, to the extent possible, throughout our lifespan, as well as to be treated with dignity and respect, no matter what the circumstances.

The hospice staff does whatever we can to give all of our patients a sense of autonomy and dignity. This is also an instinctual need for cats, who retain the imprint of their past lives as predators in the wild. Accordingly, cats do what they can not to show weakness, to prevent becoming prey to stronger animals. With Andy, this is expressed as a need to assert herself and get her way – which we accede to within healthy boundaries.

Our elders deserve our respect, and not be abused or put down for their frailties. The same applies to cats – they are proud animals. (I guess that’s why they call a related group of lions a pride!). I do what I can to give Andy the dignity and respect she deserves.

6. The need for gratitude and acknowledgement.
We all want to be acknowledged for what we have accomplished in our lives, and to feel that sense of accomplishment. Humans do this by telling our life stories, as a way to create meaning and validate that our lives have had purpose. This is called “life review.” One way we engage in life review with our nonverbal hospice patients is to look at old photo albums together, or look at magazines about their interests and hobbies.

I intentionally take time to thank Andy for all the joy and comfort she has given me throughout the years, and for all of the richness she has contributed to my life. I don’t know if she understands my words, but I believe that she understands the loving energy that accompanies the words. So, thank you, Andy, for all of your gifts, and for this new gift as my teacher in your waning years.

THE ROLE OF THE STIGMA OF MENTAL ILLNESS AND CAREGIVER BURNOUT IN THE CONNECTICUT MASS KILLINGS

I have been viewing the horrific Newtown mass murder through my lens as a psychotherapist specializing in grief, loss, trauma and caregiver support. My professional lens was sharpened by my experiences providing critical incident stress debriefing and traumatic grief counseling in the wake of the mass shooting in Aurora.

Former Pennsylvania Governor Ed Rendell observed on MSNBC (12/16/12) that the issue is how to keeps guns out of the hands of the mentally ill. I would reframe the question as how to best treat and serve the mentally ill/developmentally delayed and their primary caregivers to prevent this type of tragedy. Despite some progress, there is still much shame and stigma connected to mental illness and to reaching out for support. The lack of ready and affordable care for the mentally ill and their loved ones compounds the problem. I can’t help but think that these obstacles to mental health care played a major role, preventing both the alleged shooter Adam Lanza and his mother slain at his hand from getting the care they desperately needed and deserved.

I was struck by the description of Nancy Lanza, Adam’s mother, presented in the front page Sunday New York Times article “A Mother, a Gun Enthusiast and the First Victim” (12/16/12) by Matt Flegenheimer and Ravi Somaiya. As we have all now learned, Ms. Lanza was divorced in 2008. Her son Adam lived with Ms. Lanza full-time. He was still living with his mother at age 20, at the time of the shooting. No one else lived at the home. Ms. Lanza was described by several people who knew her as “nervous” and “high strung.” In addition to living full-time with her troubled son, she home schooled him after she became dissatisfied with the education and care her son was receiving in the local schools.

The image that came to me as I read this description was of a woman at the end of her rope, burning out from the stress and despair of caregiving for her disturbed son. Based on statistical evidence, it is likely that the difficulties in caring for Adam contributed to the breakup of Ms. Lanza’s marriage.

When I try to put myself in their situation, I imagine an atmosphere of volatility and stress, helplessness and hopelessness. I can imagine that Adam knew he “should” be living on his own, with a full time job, or away at college. I can imagine his shame and rage at his situation. I can also imagine that he projected his rage onto his mother, not only because she was there as an easy target, but also because she was a constant reminder of Adam’s perceived failings as a young man. I can also imagine that Ms. Lanza was overwhelmed by the responsibilities of caregiving for her son, and trying to maintain some semblance of a nurturing relationship with him.

I also wonder what precipitated Ms. Lanza’s enthusiasm for guns and target shooting. Many have asked why the mother of a mentally ill son would have guns in the house. Clearly, this is a sign that all was not well in Ms. Lanza’s world, and the stress of caregiving may have clouded her judgment. Without yet knowing more about that, I can also imagine that she turned to the sport of guns and shooting as an outlet in the wake of her divorce in 2008 and being Adam’s sole primary caregiver. Did Ms. Lanza reach out for support, or was she too ashamed to do so, or did she just not know where to turn for the help she desperately needed?

As a therapist providing support to family caregivers, individually and in support groups, I am acutely aware of their needs. I hear about the sense of isolation, shame, helplessness, hopelessness and despair family caregivers experience. I also hear of the verbal and emotional abuse they sometimes have to endure. It is well documented that family caregivers suffer more physical illness, as well as depression, than others in their age group, and also suffer more divorces and schisms in relationships with other family members

We need to do more as a society to remove the stigma of mental illness, open more doors to support for family caregivers and make care for all touched by mental illness more available and affordable.

YAHRZHEIT: THE POWER OF RITUALS IN HEALING GRIEF

YAHRZHEIT: THE POWER OF RITUALS IN HEALING GRIEF

The holiday season can be particularly painful for those who are mourning. This time of year is particularly poignant for me, as I have lost a number of loved ones over the years – including this year — during the week of Thanksgiving.

Although I am a practicing Buddhist, I am never far from my Jewish roots. I turned to the rituals of Judaism (with some Buddhism thrown in) as a healing tool in my holiday grief. With the coming dark days of winter, and the annual reminders of loss I face each year, I knew that ritual could help me with my holiday grief. During this time of darkness, I lit a Yahrzeit candle – a memorial candle that Jews around the world light to commemorate the anniversary of a loved one’s death. The Yahrzeit candle burns for twenty-four hours. “Yahrzeit” means “years-time” in Yiddish.

In Jewish tradition, the candle flame is often thought to represent the human soul. As it is in other spiritual traditions, the lighting of candles is an important part of many Jewish religious occasions, such as the marking of the Sabbath each week, and the lighting of the menorah during the eight long winter nights of Chanukah – the Festival of Lights.
As it is said in the Book of Proverbs, like the human soul, flames must breathe, change, grow, strive against the darkness and, ultimately, fade away. Thus, the flickering flame of the Yahrzeit candle helps to remind us of not only of life’s challenges, but the impermanence of all, and of the preciousness of our human lives – concepts that Buddhist practitioners contemplate daily.

On Thanksgiving eve at sundown, I lit my Yahrzheit candle – remembering all of my loved ones who have left this particular life – grandparents, aunts and uncles, friends, beloved pets. I let those remembrances permeate my heart like waves of warmth, as if emanating from the warmth of the candle flame. At the same time, I prayed for them, seeing the flame even with eyes closed.

I then prepared my turkey for cooking the next day, and went about my life with my loved ones in my heart.

Experiencing Physical Pain

I have practiced working with chronic pain for many years, using my mindfulness meditation practice as an aid. However, nothing prepared me for the experience the acute pain I recently endured.

I tried to relax around the pain, experience the physical pain directly without adding thoughts about it that lead to suffering, etc. – all the things that I tell my therapy clients and mindfulness meditation students. However, while in the throes of the most intense and excruciating moments of the pain, it was almost impossible to remember to breathe and relax. The following tips are intended as a reminder for myself , and an offer to others, when experiencing acute physical pain:

• Breathe and visualize creating space around the pain. Imagine soothing water or an elixir bathing the area in love and light.
• Listen to soothing music. Music can be so healing. Allow yourself to enjoy its beauty.
• Have someone rub your back, hold your hand, simply be a caring presence. It is so easy to isolate ourselves when we are in pain of any kind. Remember to reach out for support.
• Take a bubble bath, get a massage. Be kind to yourself.
• Listen to the song of a single bird. Notice the beauty of a single flower. Focusing on one thing helps calm the swirling emotions that accompany pain.
• Banish negative self-talk. This pain is not your fault or bad karma!

• Know that everyone experiences pain, and use this opportunity to develop compassion for yourself and others.
Of course, follow your doctor’s advice. When you are experiencing unusual pain, it is important to speak with your health care providers. Emotional and spiritual care are complements to physical care. As I have learned, pain is global – physical, emotional, social and spiritual. It is therefore important to support ourselves in all of these domains when experiencing physical pain.

NAVIGATING A LOVED ONE’S ANGER

It has been a long, hard day. You rush home to make dinner for yourself and your partner. He/she comes home grumpy after a frustrating day at work, throwing his/her briefcase down with a thump, sighing and ordering you to make a drink. You quickly oblige, knowing that his/her anger could quickly escalate. You rush back into the kitchen to get dinner ready and on the table. Your partner sits down with yet another sigh. You try to make small talk, which is ignored. Immediately, the dinner is criticized as too cold, and you are criticized as a lousy cook. You defend your cooking and yourself, and your partner’s anger escalates. Soon you are both engaging in a screaming match.

Sound familiar? How can you navigate your partner’s anger in a more productive way? Here are some tips:

• As soon as you notice that your partner is unhappy or frustrated, center yourself. Slow down and breathe.

• Remind yourself not to take his/her anger personally.

• Practice “tonglen on the spot.” Tonglen is a Tibetan Buddhist compassion practice in which you breathe in pain and suffering and breathe out peace, love and compassion. First do some tonglen for yourself: Breathe in your hurt feelings and the suffering you feel, focusing on where you feel it in your body. Then, breathe out peace and light into that hurt. You can then practice tonglen for your partner – breathe in his/her pain and suffering and breathe out love and compassion for him/her. This can take a very short time, and is very effective in slowing down the force of anger and increasing compassion for yourself and all others.

Our first reaction when we are hurt is to react and defend ourselves. This is a habitual pattern that may take some time and mindfulness to break. When I asked my Buddhist teacher the best way to deal with this unproductive habit, his one word response was “Disengage.” The tips described above can be very helpful in learning to disengage from another’s anger and not react.

I am also reminded of the 70s saying “What you resist persists.” One way to experience this notion is to push one of your hands push against the other one. Notice how this increases the force of energy in both hands. Now, instead of pushing against the moving hand, go with the direction of that hand. Notice how the force dissipates when there is nothing pushing against it. Another analogy I find helpful is navigating a skid: Going in the direction of the skid is what works. If you go against it, you’ll be in trouble.

Similarly, like in the scenario presented at the beginning of this article, if you defend against anger by pushing against it, the force of that anger will increase. Find a way to let your partner’s anger be rather than resisting it. Breathing and knowing that it’s not about you will help. Saying “I’m sorry you had a hard day” may be one way to do it. If that doesn’t work and your partner can’t control his/her anger, you may have to leave the room until he/she settles down. Continue to remember that your loved one is hurting and doesn’t know how to handle it at that moment. When things quiet down, the two of you can work together to come to an agreement as to how to handle anger in your relationship in the future.

Using Mindfulness Meditation to Tame Intrusive Thoughts

Intrusive thoughts — those pesky thoughts that can spiral from a simple thought into a full-blown novel — can interfere with our work life, as well as our life in all other areas, interrupting our sleep, intruding in our relationships and in enjoying our lives in the moment. We give so much power to our thoughts. Learning to let them go and not attach importance to them can be tremendously liberating. This is especially so with thoughts that are self-critical.

The first step in dealing with those intrusive thoughts is to be aware of them. Mindfulness meditation can be extremely helpful in dealing with our thoughts. Here are some basic instructions:

• Sit comfortably in a chair or on a cushion, making sure your back is straight yet relaxed, so that your breath can flow freely. If you are sitting in a chair, uncross your legs, feeling both feet on the floor. Unclench your jaw muscles, by resting the tip of your tongue directly in back of your teeth. Have your hands rest comfortably on each thigh, palms down.

• Breathe — notice your in-breath: the rise of your abdomen and chest, the feel of the cool air coming in through your nostrils. Then notice your out-breath — warm air coming out your nostrils, letting go of stress, the fall of your abdomen and chest. Notice the pause before the next in-breath.

• Continue breathing in this fashion. As thoughts arise, simply label them “thinking” and come back to the breath. If you find yourself caught in a story or discursive thinking, simply notice that, without judgment, let it go and come back to the breath.

Practice this for a few minutes each day, slowly increasing the time of each session. The key is to do this every day.  It may be helpful to have an experienced meditation instructor guide you through this practice.

Another technique that I often use with my clients is called “the container”:

• Visualize a container or box with a lid or other top, something you can evoke simply.

• When thoughts arise that are getting in your way, consciously say to yourself, “I do not need these thoughts right now”, and put them in your container, and close the lid or top.

Something else you can do is to visualize your energy going from your head — where all those intrusive thoughts are buzzing around — to your feet. Put both feet firmly on the ground, feeling the floor or ground beneath you, and bring your energy to your feet. This is very grounding as well as a good way to release those pesky thoughts.

It is amazing how much time we spend in our heads, and are not present with whatever it is we are doing or feeling. This is a “curse” of being a thinking human being. With our fast paced world, we are often multi-tasking, on our iPhone, iPad and MacBook all at the same time!. Take a break from your devices.

Another very effective way to slow down those intrusive thoughts is what I call “driving meditation”. The goal of this exercise is to drive when you are driving. Here are the steps:

• When you get in your car, turn off your cellphone and all other devices, including the radio.

• Have the intention to be present with your driving.

• Notice how it feels to put the key in the ignition, then listen to the sound and feel the vibrations as you turn on the car.

• Feel the tires on the road as you drive. When your mind wanders, notice that without judgment, and come back to being present driving, feeling the tires, seeing the road and the flow of the traffic, listening to your car engine and the other cars around you.

• When you get to a stop sign, actually STOP and take a breath, noticing where you are, both inside and out, and then proceed. As my Buddhist teacher says, “Don’t do a California Roll through the stop sign!”

We all have an inner-critic — that voice inside our heads that judges and criticizes ourselves. These mindfulness techniques are so helpful in freeing ourselves from these self-negative thoughts. After meditating for a while, I actually gave that critic a name that was different from my real name, as well as a different voice than my actual voice. After a year or so of meditating, a friend asked me how it helped me. After pondering her question, I answered, “Wow! I no longer mentally beat myself up, and that’s a miracle!”

Life, Love and Work: How to Navigate Life in the Workplace After A Loss

Life cannot be compartmentalized. Life and loss happen at the same time that you are expected to fulfill obligations at work. Here are some tips for dealing with challenging life events and remaining productive.

The challenge of maintaining emotional stability at work while going through a divorce, death or other major loss is called a “dual process” – on the one hand, you are navigating your loss, and on the other hand, you are getting back into your life and its obligations.

It is important to attend to your loss.  If you try to push your loss under the rug and not deal with it, this can lead to delayed grief, a form of complicated grief.  In order to prevent this, it is important to have support – reach out to others who have gone through a similar loss.  Join a support group. Get emotional sustenance from your spiritual community.  Get professional support from a counselor specializing in grief and loss.  Express your feelings to a trusted friend or co-worker.

Grief and loss can make us question things we always believed in, and journaling or other forms of expression can help us create meaning.  Take care of your physical health.  Grief is extremely stressful in all areas, including the physical.  Make sure you’re getting enough sleep and eating healthily.  See your doctor to support you in maintaining your physical health.

If you attend to your physical, emotional and spiritual health, you will be more successful in re-entering the workplace and maintaining emotional stability on the job.  Don’t forget, though, that you aren’t perfect and that “grief spasms” can come without warning.  If you get sad or angry and start to cry or snap at a co-worker, excuse yourself.  Take a two-minute break.  Breathe in cool, nourishing air, and breathe out stress and tension.  Roll your shoulders and neck as you breathe in this way.  Feel your feet grounded firmly on the earth. It may be helpful to confide in a trusted co-worker, and ask him or her to remind you to take those mini-breaks.

It is important, though, to maintain a balance regarding how much you share about your personal situation at work.  If you feel that your feelings around your divorce or other loss are interfering with your job performance or if your situation requires you to take time off from work, you may want to explain to your boss — in professional and non-emotional terms — what is going on and that you are going through a difficult situation and you are confident that you will get back to peak performance shortly.

It is also good not to confide in too many work colleagues about your personal life – keeping a boundary between your personal and professional life is important in all circumstances.   Additionally, work can be an “oasis” where you can just do your job and put your feelings aside for a while.  We all have our own balance point, and it is important to be mindful when you are tipping to the side of expressing too much about your personal life.

If you are unable to get the emotional stability to do your job, whether you are feeling overwhelmed by your loss, are finding that the pain of your loss remains fresh with little relief, are having intrusive thoughts that are preventing you from sleeping, having negative beliefs about yourself or other difficulties, a therapist who specializes in grief and loss can be extremely helpful.

How to Be with Someone who is Grieiving

Your best friend’s beloved cat just died.   Your favorite co-worker was just laid off.  Your elderly aunt, who suffered from cancer for many years, just died and your cousin is bereft.  In any one of these situations, you might likely be uncomfortable, and don’t know what to do.  You are certainly not alone with this dilemma.

The first thing to remember in being with someone who is grieving a loss is the word “be” – notice that the title of this article starts with “how to be”, not “what to do.”  You may be tempted in the case of the death of your best friend’s cat to offer to take him to get a new pet.  In the case of your laid off co-worker, you might be tempted to give her resume- writing or job-hunting tips.  In the case of the death of your aunt, you may be tempted to tell your cousin that the death was a blessing and at least she lived a long life.

Although these possible reactions sound like they might be helpful, they actually can do more harm than good at the beginning of someone’s grief process. Here are some “doing” things to avoid:

  • Avoid the temptation to fix it.  People don’t like to feel that something is wrong with them that needs to be fixed.
  • Avoid giving advice, unless it is asked for.
  • Avoid the use of clichés, such as “maybe it’s a blessing” or “I know just how you feel” or “God works in mysterious ways.”

The key to being with a grieving person is listening.  Sounds easy, doesn’t it?  However, listening is really not that easy for most of us.  We find it much easier to do than to be.  So, we give advice, or offer to fix it or do something else to fill the space.  It is difficult for us to sit in silence with another, being a caring presence.  We tend to be uncomfortable witnessing another’s suffering and sitting in that empty, groundless space.  So, we do things to fill that silent space that are well-intended but not helpful to the grieving person.

The following are some keys to effective listening and being a caring presence for someone who is grieving:

  • Center yourself before entering the room.  Have the intention of being present for your friend. Slow down. Breathe mindfully, inhaling nourishment and ease for yourself and your friend, and exhaling stress and tension.  Feel your feet on the floor in order to get grounded.
  • Leave all distractions aside.  Turn off your cellphone, iPad and computer.  Don’t worry – your messages will still be there and can wait.  Forget about your plans for the rest of the day — they too can wait.
  • As you sit with your friend, check in with yourself periodically, putting about seventy-five percent of your attention on your friend, and about twenty-five percent on yourself.  Check to see if you are staying present – Is your mind wandering? Are you jumping ahead and figuring out the next thing to say?  Are you getting anxious hearing about your friend’s loss?
  • Leave your agenda at the door – simply be with your friend as he or she is at that moment, as much as your might wish to make it better or different – remember that it’s their process, not yours.
  • In staying present, be aware of your own triggers.  Perhaps you lost a beloved pet, just as your friend just did, and being with your friend is triggering your own pain.  Breathe into that pain for yourself, and breathe out from that tender place for your friend.  Your own pain is truly an opportunity to be authentically and open-heartedly present with your friend, and an opportunity for healing for both of you.

 

There is nothing more healing than feeling truly heard and understood.  This is the essence of active listening and “companioning”:  being with another in life’s journey as equals on the path.  Listening to and being a mirror for another’s pain is the essence of companioning.  As the eminent humanistic psychologist Carl Rogers noted:

I find that when I am close to my inner, intuitive self, when I am somehow in touch with the unknown in me…whatever I do seems to be full of healing. Then, simply my presence is releasing and helpful to the other. There is nothing I can do to force this experience, but when I can relax and be close to the transcendental core of me…it seems that my inner spirit has reached out and touched the inner spirit of the other. Our relationship transcends itself and becomes a part of something larger. Profound growth and healing and energy are present (Rogers, A Way of Being, 1980).

USING MINDFULNESS-BASED PSYCHOTHERAPY AND MINDFULNESS MEDITATION TO OVERCOME TRAUMA

As a psychotherapist specializing in trauma and grief, the tenth anniversary of 9/11 gave me the opportunity to contemplate anew working with trauma — including my own. I was an eyewitness in New York City to the horrors of the terrorist attacks on the World Trade Center that beautiful September day. All of the media attention about the 9/11 anniversary could have reactivated serious traumatic reactions if I were not mindful of my thoughts and body sensations. I was aware that seeing footage of the collapse of the towers and revisiting other events of that day made my heart race and my hands tingle. I was also aware that my thoughts were careening back to the events of that tragic day and my feelings of helplessness and hopelessness. Staying mindful of the present moment helped me work with my thoughts and feelings. Focusing on my breath rather than my thoughts, I was able to breathe into my body sensations and emotions of fear and anxiety, and breathe out calm, healing and compassion for myself and all others experiencing those feelings.

Unresolved trauma — whether from abuse, witnessing or being a victim of violence, grieving a sudden or painful death, being in a car accident, or a myriad of other difficult events — can affect every aspect of a person’s life: physically, socially, emotionally, cognitively and spiritually. For example, intrusive thoughts and images can impact a person’s sleep, eating and overall health. The body’s flight, fight or freeze response to unresolved trauma can impact a person’s social and emotional life. Trauma is usually accompanied by negative beliefs such as “I am not safe”, I do not deserve love”, “The world is a terrifying place”, “God cannot help me”, “I deserved to be hurt.,” which affect the traumatized person’s sense of self, world view and spirituality.

Mindfulness meditation and mindfulness-based psychotherapy can be powerful tools in healing trauma. Mindfulness meditation helps free people from the seeming power and “truth” of their thoughts, helping them stay in the present, rather than dwelling on the past or worrying about the future. In addition, many people dealing with depression, anxiety or trauma are not connected to their bodies. They literally live in their heads. This is a coping mechanism to escape the pain of their feelings — it may have served them in the past, but is no longer serving them. Mindfulness meditation helps a person focus on the present moment and notice where thoughts and emotions are felt in the body. This experience can help the traumatized person feel grounded. The simple act of feeling one’s feet on the floor, feeling the support of the floor and Mother Earth, is especially effective in letting go of racing thoughts about the past and future and being grounded in the present. This grounding helps clients feel safe in the present,

Mindfulness practices keep us in contact with things as they really are, helping us let go of the seeming power and solidity of our thoughts. Dealing with the past in the present moment creates spaciousness and workability around swirling and claustrophobic thoughts and feelings. Thus, mindfulness based psychotherapy allows traumatized clients to re-experience the traumas of the past while being in touch with their present thoughts, feelings and body sensations. The experience of the present moment actually provides a sense of safety and distance from past horrors. We are able to experience as a witness the thoughts, feelings and emotions associated with the past without being stuck in them, simply letting the experiences come and go. This witnessing ability is extremely powerful, allowing us to see that we are not our thoughts or our past experiences.

Physiologically speaking, working with the present body sensations, emotions and feelings associated with the past actually releases traumatic material that is literally stuck in the amygdala, or “reptile brain.” This stuckness affects our adrenal system and other body systems as well as our brains, resulting in the automatic flight, fight or freeze response Mindfulness practices facilitate the release of traumatic images from the brain, making them less intrusive. In turn, the individual can choose more healthy responses than fight, flight or freeze, let go of negative thoughts about him or herself, and actually replace those thoughts with positive thoughts.

As one client grieving the traumatic death of her husband noted, “I still miss him, and still have images of him being in the ICU on life support, but those images no longer intrusive and disturbing. They are now just memories, and the negative beliefs about myself and the world are gone. I know that my husband’s death was not my fault and I am OK.”