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).


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.”

Using Anger Mindfully

Many of us, especially those on the spiritual path, tend to look at anger as an entirely negative emotion.  However, anger used mindfully can be extremely positive, powerful and ultimately healing.  Anger is simply energy, and we always have a choice as to what to do with it. Dzogchen Ponlop, in his recent book Rebel Buddha (2010) aptly states:

We usually think of anger … as negative.  Ordinarily, our impulse would be either to cut through it and get rid of it or to transform its intense energy into good qualities like clarity and patience….[T]he  direct experience of our unprocessed, raw emotions can generate a direct experience of wakefulness. These emotions are powerful agents in bringing about our freedom, if we can work with them properly (p. 144).

So, what do we do that that energy?  We are often afraid to feel its raw power, and fear that expressing it will make us seem less than the kind compassionate people we are.  However, using anger mindfully will actually awaken our compassion, starting with compassionate lovingkindness toward ourselves.

In fact, many people who are compassionate toward others do not treat themselves with the same degree of compassion, and are self-critical and often depressed.  It has been said that depression is “anger turned inward.”  One of the major goals in treating depression in psychotherapy and in grief counseling is to help clients feel safe to express their anger, and turn the energy of anger outward.  “Ex-pressing” anger literally means pushing it out, so that it becomes workable and is not a toxic agent against oneself.

Anger in its pure form, without the “additives” of concept and labeling it as a bad thing, is simply energy.  The key is to harness that energy through the use of mindfulness.  Mindfulness enables us to recognize the anger without simply reacting — either spitting it out against another or turning it against ourselves.  By looking at it without reacting, we have the ability to choose to use our anger productively.

The following are some suggestions for using anger mindfully:

  • Notice how anger manifests in your body — is it a burning sensation in your heart?  A cold tight clenching in the pit of your stomach?  A flush of heat in your face or hands?  Become as familiar as you can with your own unique physical “early warning signs” of anger so you can catch its energy without reacting.
  • As soon as you notice the physical sensation of anger, stop and breathe.  Allow the energy of anger to wake you up to what is actually happening at that moment.
  • Give yourself permission to feel hurt, abandoned, scared, frustrated or sad with a sense of compassion for yourself.  Breathe in light, peace and compassion, and breathe out the dark, heavy sensations of anger without judgment, accepting it just as it is.
  • If you notice the anger turning inward against yourself, continue to breathe it out more forcefully.  Use your body to keep the energy of the anger outward — shake it off your hands into the air, stomp it into the ground with your feet  — whatever it takes not to turn that energy against yourself.
  • Be curious.  Ask yourself:  “What is this feeling?  What is it telling me?”
  • Trust your body to tell you the appropriate course of action.  Is there something you need to say to someone who has hurt you, in a way that will forward your own healing and contribute to the growth of the other person and your relationship with him or her?  Is it something you can simply let be, making sure not to turn the anger inward?

As Stephen Levine (1987) eloquently says, “the investigation of anger…leads us directly to the love beneath, to our underlying nature. When we bring anger into the area where we can respond to it, where we can investigate it, where we can embrace it, it emerges into the light of our wholeness….Then anger is no longer a hindrance, but a profound teacher.”


Dzogchen Ponlop (2010).   Rebel Buddha: On the Road to Freedom.  Boston:     Shambhala Publications, Inc.

Stephen Levine (1987).  Healing into Life and Death.  New York:  Doubleday, a division of Bantam Doubleday Dell Publishing Group, Inc.

© 2011.  Beth S. Patterson, MA, LPC.  All rights reserved.


Despite a few flaws, “Rabbit Hole”, starring Nicole Kidman and Aaron Eckhart, provides an excellent portrayal of grief.  The stars’ characters, Leah and Howie, play a married couple who lost their 4-year old son to a car accident eight months prior.  All of the emotions of grief — shock, sadness, anger, guilt/blame, regret — are enacted by the main characters, as well as by Leah’s mother (Dianne Wiest), and the teenage boy who caused the accident, swerving to avoid the family’s dog, and killing Leah and Howie’s son, who ran into the road after the dog.

Leah and Howie assiduously try not to blame each other for the accident.  Instead, and as a result, they each blame themselves.  At the same time, they both know realistically that they are not to blame –but heart and head are simply not the same.  Themes of life’s constant moment-by-moment changes run through the movie, and a scene of Leah planting flowers, and a neighbor accidentally stepping on one, breaking it in two poignantly shows how fragile and ephemeral life is.  Yet, we hold on to the hope that nothing dies.  Certainly a four-year old boy should not die.

Change is part of the grief process too.  Grief changes us.  We are never the same after a major loss.  In fact, part of the process of grief is to find one’s “new normal.”  Conversely, as we change, our grief changes. As Leah’s mother eloquently describes it, grief is like a brick in one’s pocket — we always feel it, but over time it feels less heavy.  After some time, we can actually forget that it’s there sometimes, but memories come back, and we feel the brick again.

Leah and Howie struggle to make sense of their loss.  Sense-making is one of the paramount parts of the grief process.  They join a support group of grieving parents, who all strive to make sense of their tragic losses. Some turn to God in trying to make sense of the process, saying “it must have been God’s will.”  This statement infuriates Leah.  It is too bad (one of the movie’s flaws) that there was not an experienced grief counselor facilitating the group to validate both responses and work with Leah’s rage at God.              Howie thinks of starting an intimate relationship with another grieving parent as a way to cope with his loss.  This demonstrates how grief changes a marriage.  A family is a system, and the couple in a marriage is a system within that system.  A system is like a mobile, always trying to create equilibrium.  When an integral piece of the mobile/system is removed — here, Howie and Leah’s beloved son — the mobile/system sways wildly, trying to create a new equilibrium.  “Rabbit Hole” is about the process of finding a new equilibrium, a new normal, in the marriage of Leah and Howie.   The work of a grief therapist entails helping members of a family to create their own unique and healthy equilibrium, make sense of their loss, and find a new way of being in the world, transforming loss into healing and growth.

Journaling: A Powerful Tool for Grief and Difficult Life Changes

I often suggest journal writing to my clients who are grieving the death of a loved one or dealing with a difficult life change as a useful way to deal with and befriend the intense emotions that often accompany these experiences.  Some say, “oh, I’m not a good writer.”  To that I reply that what is important is the act of expression, not how pretty or correct it is.  In fact, the word “express” literally means “push out”, that is, pushing out all of those churning, claustrophobic and chaotic feelings in a way that gives them “breathing room” and makes them workable.  The following are some tips for the use of journaling as a healing tool in grief and other difficult life transitions:

1.  Write in longhand, rather than typing. The act of putting pen to paper is a physical act of expression and “pushing out” whatever is churning inside you, and in my experience it is more effective than typing.  Don’t worry about your penmanship — just get it out.  The appearance of your written words on the page may hold some truths you have not yet realized.

2.  Don’t worry about spelling, grammar or correctness. This is a right-brained (emotional) experience, not a left-brained (rational) one.  Again, just get it out in stream-of-consciousness fashion.  You may be surprised at what you push out.

3.  Breathe. Let your body be part of the process.  Notice what you feel and where you feel it in your body.  Our bodies hold more truth than our thoughts do.  Feel what you are feeling and go with that.  If you need to cry, do so, and keep on writing.  You can let your tears fall on your paper as part of your expression.

4.  Write mindfully. Stay in the present as your write.  Feel your pen on the paper.  Notice the textures and movement of your hand, eyes and the rest of your body.  Feel your breath.  Notice your thoughts, and when they wander, take a breath and come back to the pen, paper and act of writing.

5.  Use letter-writing as part of your journal. Are there things you are yearning to say to a loved one who has died?  It can be helpful sometimes to write those things in your journal in the form of a letter to your loved one.

6.  Write down your dreams. Dreams can be a powerful source of healing in grief and life transitions, and writing them down is a great way to remember and learn from them.  Keep your journal by your bed, and when you go to sleep, tell yourself that you will remember your dreams.  When you start to awaken from a dream, stay in a semi-sleeping state and write down a few key words that will help you remember the dream when you wake up, and then write as much as you remember from the dream.  Be aware of your emotions and body sensations as you recall your dream through writing.

7.  Draw pictures. Sometimes our emotions can seem to overpower our ability to write.  Just draw what you are feeling, again in a stream-of-consciousness fashion, not worrying about what it looks like.  It can even be lines and shapes. This can be another powerful way to get our feelings out in a way that makes them workable.

8.  Connect with a power higher than yourself. I truly believe that the more we allow ourselves to feel our pain, the more compassion we develop for ourselves and all others who are in pain.  This in turn helps us connect with a sense of transcendence, whether one calls it God, Buddha Nature, Christ Nature, or the Ultimate.  Allowing ourselves to feel and express our intense pain in the safe space of journal writing  is an opportunity for real healing, transformation and growth.

Winter, Grief and the Dark Night of the Soul

Winter, nature’s dark night of the soul, has been viewed in many faith traditions as a time of spiritual questioning and aridity, a time of turning inward in a search for what is personally important, a quest for spiritual union.   This journey can be a difficult one, full of sadness and loneliness.  Our losses can be felt most poignantly at this time.  It can be excruciatingly painful as the holidays remind us of times when our loved ones were with us.  The pain of our losses, coupled with the darkness and holidays, can seem too much to bear at times, and we try to cover our pain with liquor or other escapes.

Rather than resulting in permanent devastation, the dark night of the soul is viewed by mystics and others as an opportunity for profound personal and spiritual growth.  Growth comes from touching into our pain, not turning away from it.  The dark winter months can actually aid us in this process if we allow the darkness to envelop us like a sweet blanket of warmth, protecting our hearts as we feel our pain.  As expressed by psychiatrist Gerald May (2004) in his book The Dark Night of the Soul: A Psychiatrist Explores the Connection Between Darkness and Spiritual Growth:

“The dark night is a profoundly good thing. It is an ongoing spiritual process in which we are liberated from attachments and compulsions and empowered to live and love more freely. Sometimes this letting go of old ways is painful, occasionally even devastating. But this is not why the night is called ‘dark.’ The darkness of the night implies nothing sinister, only that the liberation takes place in hidden ways, beneath our knowledge and understanding. It happens mysteriously, in secret, and beyond our conscious control. For that reason it can be disturbing or even scary, but in the end it always works to our benefit.”


The following are some suggestions for turning in to our pain and finding growth and spiritual union:

  • Journal – This act of expression can be powerfully helpful in pushing out the swirling confusion of emotions so that they become workable.
  • Engage in meaningful ritual – Light a candle in honor of your loved one, set an extra place at the holiday table, go to your loved one’s resting place, make a donation in your loved one’s name or any other activity that helps guide you toward peace.
  • Take care of your health – This time of year, with the added burden of grief, can be extremely stressful, and it is important to attend to our physical health.  Make sure to drink lots of water and eat healthy food.
  • Move your body – Take a walk in the fresh crisp air, do yoga or any other physical activity that engages your body and mind.
  • Practice mindful walking – notice each step and connect to Mother Earth.  Notice your breath, breathing in peace and nourishment, breathing out stress and pain.  Feel that sense of peace and nourishment and letting go of stress and pain first for yourself, and then for all others (which is everyone!) who are experiencing pain and suffering.
  • Give yourself a gift that your loved one wanted for you, whether a material gift or a gift of relaxation, such as a massage.
  • Spend time in nature, with compassionate friends, and schedule “dates” with yourself, treating yourself kindly as a friend.

The Lonely Grief of Losing a Loved One to Dementia

The grief involved in seeing a loved one lose his or her capacities to Alzheimer’s disease and other dementias is among the most difficult we can experience.   One experiences the ongoing day-to-day horror of witnessing a loved one slip further and further away.  There are myriad other losses faced by a spouse or partner as their loved one slips into dementia:  the loss of couple activities, the loss of friends who are uncomfortable with the situation or don’t know how to respond, the loss of one’s hopes and dreams for the future and growing old together.   You just don’t know where you fit in any more.  The day your beloved stops recognizing you is among the most painful on this journey.

All of the experiences of grief identified by Elizabeth Kubler-Ross confront a couple after a diagnosis of dementia.  Shock and denial are common — many people faced with this terrible diagnosis hope against hope for a quick cure or hope that the diagnosis was wrong.  Anger is a major component of the process, and can either tear the couple apart or bring them together at the beginning stages of the disease process as they forge a new relationship in uncharted territory.  Depression is certainly a risk in going through the inexorable, seemingly never-ending grief of living with a person with dementia, as well as for the person with dementia as he or she loses their independence and daily functioning.  Guilt is also common — often a loved one feels guilty going on with and enjoying his or her life.

The following are some suggestions for self-care for those living with a loved one with dementia:

  • Allow yourself to feel your anger and use it productively.  This can be a time of deep questioning of one’s religious and spiritual beliefs.  Talk about those questions with friends and clergy.  This “dark night of the soul” can ripen into a deeper spiritual strength, which is an invaluable inner resource in the grief process.
  • Express yourself — journal, write poetry, draw or paint, dance or move to yoga.  Getting those churning feelings out, i.e., “ex-pressing” them, is vital in preventing depression and burnout.
  • Speaking of burnout, take time for yourself.  At first you may feel guilty.  However, nourishing alone time — walking in nature, in a yoga class, having a massage — and time with supportive friends and family is vital in preventing burnout.  If you burn out, you won’t be able to be there for yourself or your loved one.  As they say in the safety announcements on an airplane, you need to put your own oxygen mask on before you can help the person sitting next to you.
  • Join a support group with others who are losing a partner to dementia.  The Alzheimer’s Association has a tremendous wealth of resources to support family caregivers.
  • Speak to a therapist or counselor who understands the process of grief you are going through. Use that time as your own special, sacred time to deal with all of the feelings you are going through, including feelings about other losses and hurts in your life that may be surfacing.

In sum, self-care and being with others is critical as you go through this process.  May you learn and grow as you journey on this road of loneliness and grief.

Grief After Suicide: A Personal and Professional Perspective

Despite the suicide of my best friend many years ago,  I sometimes still reel from the loss and experience profound grief. This is especially so on anniversaries, birthdays, and when suicide is in the news.

My initial reaction to my friend’s sudden death was shock. I was unprepared for her death. In the months following her suicide, I experienced a myriad of intense emotions: Of course, I was sad to lose my best friend. I had a bit of guilt, but primarily feelings of helplessness that there was nothing I could have done to prevent her self-destruction. I also felt a sense of shame, and was afraid people would condemn me somehow for allowing a friend to take her own life, despite the fact that I knew I had no control over her death. Perhaps the most intense feeling I experienced was anger. My feelings of anger would hit unpredictably, often when I was driving. I would smash my hand against the steering wheel and wail in anger and anguish — How dare she leave me without saying goodbye? I hope no one saw me – they would surely have tried to have me committed!!

And yet, despite the seeming insanity of my profound grief, I knew, as a grief counselor, that my reactions were normal and that in fact my anger was healthy — better to extend my feelings of anger outward rather than turn my negative energy inward in a way that can fester in negative self-thoughts and depression.

All these years later, my grief can hit unpredictably — while listening to a piece of music that I associate with my friend, when I have accomplished a goal she would have been happy to share in with me or other times. I have learned, both personally and through my professional work, to prepare for the more predictable moments of grief, such as my friend’s birthday or the anniversary of her death. I have always told my bereavement clients that those anniversaries and important days stay in our bodies — sometimes our bodies know it before we do. In fact, I found myself walking around feeling particularly irritable and out of sorts about two years after my friend’s death, only to realize later that it was in fact her birthday! My body knew it before my mind did. So, I practice what I preach and prepare for those important days and create rituals around those days. For example, I light a candle on the anniversary of my friend’s death each year.  Nonetheless, my grief is still unpredictable, and can be triggered by events in the news, especially other suicides.

As I discussed in another blog post, suicide can be a form of “disenfranchised grief”, i.e., a grief that is not accepted by society, in this case, because of the nature of the death — Thus my feelings of shame. It was difficult for me to share my grief, other than with those who knew my friend or had experienced a similar loss, out of fear of judgment or invalidation. As a result, I was often left feeling isolated and alone in my grief.

As a grief counselor, I tell my clients that we do not “get over” the death of someone close to us. Rather, we need to go through the pain of our grief. That process can be profoundly healing and transformative. We can find a place for our loved one in our life and in our heart. I know that my friend is still there for me as a guardian angel, and I still ask her for guidance and support.

Suicide grief is understandably difficult, and it is important for those left behind to get support — whether through friends, family, spiritual community or a professional grief counselor, psychotherapist or grief/suicide support group. It is important to take care of ourselves — eat well, get exercise, sleep — because grief is exhausting and stressful. Journaling and other forms of expression can be immensely helpful for getting out the myriad of swirling emotions and thoughts. As someone who not only “talks the talk” but has “walked the walk,” I know how important it is to allow ourselves to go through the pain of our sudden loss and get support in the process in order to heal and grow.

Helping the Person with Dementia Grieve After the Death of a Loved One

Caregivers and family members often ask whether they should tell a loved one with Alzheimer’s Disease or other dementia about a death in the family, and how they can help them grieve.  Although much has been written about the profound grief of caregivers and other family members throughout the course of the successive losses associated with dementia, surprisingly little has been written about bereavement in the dementia patient.

The loss in cognition of a person with dementia does not mean that the person does not feel the loss somatically or emotionally.  Although the individual might not be aware cognitively of the loss, he or she may have a vague sense that something isn’t right.  Just like a child knows when a loved one is not around, the person with dementia may sense a loss of contact with a loved one in his or her body. The concept of “death” may lack meaning for them, but they know — or rather feel — that something is amiss. People with dementia thus have the capacity to grieve.  Learning their language and sense of reality is important in helping them grieve a loss.

The following are some suggestions for communicating the death of a loved one to a person with dementia, and helping him or her grieve:

  • Tell the person with dementia once that a loved one has died and assure him or her that both he or she and the deceased are fine. It is respectful to tell the truth, and do so as simply and caringly as possible.
  • When telling him or her for the first time about the death, make sure there is enough time for the person to process this information to the best of his or her ability, and to cry or otherwise react.  Being in a comfortable, quiet and familiar setting can be helpful for the dementia patient to process the information and feel safe to express his or her feelings.
  • If he or she continues to ask “Where’s Mary?”, saying that Mary is dead will likely be incomprehensible and may actually re-traumatize him or her.  Telling him or her each time that their loved one has died can be like hearing it for the first time over and over. It is best to simply say that Mary is not here now, and then ask questions to check the patient’s current reality and where he or she is in the memory process.  Asking the individual where he or she thinks Mary is can be helpful in eliciting feelings.
  • Explore what age the person believes he or she is in order to gauge what memories of the deceased he or she may have, and explore those memories as a way to bring the person who died to life as a source of comfort.
  • Redirect the person from thinking to feeling. Language that elicits feelings instead of thoughts can be very helpful, since the person with dementia lives in the feeling rather than the thinking world.  If the person with dementia asks “Is Mary dead?”, a helpful response might be “Yes, and she’s OK — what does it feel like to you that Mary’s not here?”
  • Show him or her old pictures of the person who died that are contemporaneous with the state of their memory, and elicit memories and feelings in that way.
  • Artwork can be a powerful way for the individual to express feelings of loss.
  • Likewise, playing a favorite song can elicit feelings and memories, and can be a source of comfort.
  • Perhaps most importantly, remember that the person with dementia has not “disappeared” — the core essence of who he or she is as a feeling, spiritual person  is still there.  As the title of Lisa Genova’s beautiful novel about a woman with dementia states, she is “Still Alice.”  It is our job as professional and family caregivers to reach and communicate with that spiritual essence, whether through touch, life review, music, art, nature or whatever vehicle best reminds the person that it is safe for them to feel their loss and that they are okay.