IIC 17: Loss, Grief, Mourning and Resilience – How do They Go Together?

Dr. Peter covers loss, grief, and mourning, including four more unusual variations on grief.  This is the first of a three-episode series on grief and resiliency, and this episode introduces the topic.

[00:00:12] Welcome to the podcast Coronavirus Crisis Carpe Diem, where you and I rise up and embrace the possibilities and opportunities for spiritual and psychological growth in this time of crisis, all grounded in a Catholic worldview. We go beyond mere resiliency to rising up to the challenges of this pandemic and becoming even healthier in the natural and spiritual realms than we were before. I’m clinical psychologist Peter Malinoski, your host and guide with Souls and Hearts at soulsandhearts.com. Thank you for being here. I am really excited to be here with you as we enter into episode 17. This is released on May 25th, 2020 and it’s entitled Loss, Grief, Mourning and Resilience: How Do They Go Together? Now, some of you have been in touch with me, and you’ve asked me to get into the topic of grief. We touched on it briefly in episode three, when we talked about the loss of the Eucharist with the lockdowns in this pandemic. There’s been conversation about grief on the discussion boards in the Resilient Catholic Carpe Diem community space at Souls and Hearts. And now, now we’re going to go into a deep dive into this whole area of grief. We’re going to do three podcasts on grief in the coronavirus. I’m going to be doing also one Zoom meeting. That’s a real small, intimate getting together of 6 to 12 people. We’ve already got ten people registered for that. So seating is really limited. I’m only taking 12. That meeting is coming up this Friday, May 29th at 7:30 p.m Eastern Time. So check that out at soulsandhearts.com. If you haven’t registered for the community, soulsandhearts.com, go to Resilient Catholics Carpe Diem. That’s the place where you need to be. Joining is free for the first 30 days. After that, 25 bucks a month. We’ll talk more about that later.

[00:02:07] Grief. Now our thinking can get really impacted, it can be really negatively impacted when we are experiencing intense emotions. So let’s really get some clarity around all these things about grief. The first thing really quickly is to define a few terms, just so that we can have a common language and a common understanding of the topics that we’re bringing up. We’re going to start with the concept of loss, actually. Why? Why loss? Well, loss comes before grief. Loss always comes before grief. Loss precedes grief. And so we’re going to go in order here. We’re going to go in order here, and we’re going to start with loss. So there’s two Kinds of loss. There’s actual loss, actual loss. And then there’s also what I call the loss of potential actual loss, loss of potential. All right. Let’s get into these. What are these? Actual loss is the loss of a real tangible good. Something good is taken from us. It could be the death of a loved one. We lose the relationship. We lose the connection, the intimacy, the love from that person, at least as experienced in the natural realm, in the here and now, walking on the face of the earth.

[00:03:37] It can also mean the actual loss of some part of us. You know, for example, the loss of our hearing, some kind of physical capacity, the loss of our vision. It could be the loss of our job, something real, something tangible, something that exists outside of our experience. That is actual loss. Okay. Loss of potential. What’s that? The loss of potential is the loss of possibilities that we hoped for. It’s the loss of something we anticipated in the future. A wedding that will never happen. Children that will never be born. A promotion that is never going to come now. It also includes words that were never said, words that were never heard, forgiveness that was never received or never offered, stories that will never be finished. It’s the loss of something that could have been, but now never will be. Lots of the grieving that happens at funerals, I think, actually is about potential loss, particularly if the deceased was a difficult person. Problems in life. There’s a lot of times when, for example, the loss of an abusive, alcoholic, philandering husband, the grief is about what could have been in the relationship, not what actually was. So that’s a symbolic loss. It’s a loss of potential. There is going to be no living happily ever after for that grieving wife. So what is grief? All right. We’ve got what loss is, actual loss, loss of potential.

[00:05:29] What’s grief? Grief is our individual experience of loss. Right? So remember, the loss is the good we no longer have. Grief is our internal reaction to that loss. It’s our experience inside of that loss. And that experience is emotional, right? It’s got elements of sadness, anxiety, irritability, maybe mood swings. You know, it all depends on kind of how we’re set up psychologically, right? But it’s got those emotional aspects. Could be a lack of emotional aspects, numbness, apathy, something like that. Grief is also psychological, right? We could get hammered with disbelief, impaired concentration, problems with attention, flashbacks, ruminations. We could be going over and over again the memory of a person, right? Psychological factors. Grief’s also physical, right? Those tears flow. That’s a physical reaction. There might be intense fatigue, headaches, could be loss of appetite, trouble sleeping. Grief can also be expressed through behavior. The heavy sigh. We put our hands on our head. We groan. We withdraw. We sit alone in a dark room. Behavior. So the experience of grief, one thing really important about this, it varies a lot from person to person and situation to situation. Grief can be really painful, sometimes exquisitely painful, sometimes horrendously painful, sometimes so bad it could seem intolerable. Sometimes, though, grief is a lot more quiet. It may also be bittersweet. It may even have a sense of peace about it, such as when a loved one suffering from a long terminal illness dies well. So there are different kinds of grief, and we’re going to get into this later in the podcast.

[00:07:27] But for now, let’s understand that grief is our individual experience of loss. It’s what happens inside of us when we lose something or someone. All right. So with grief comes mourning. All right, what is mourning? We’ve got the loss, we’ve got the grief. Now we’re dealing with mourning. What’s mourning? Mourning is our public expression of our grief. It’s what we show to other people. Mourning is how we manifest our grief. It’s how we share our grief with others. It’s how we connect in grief. And some of this is conditioned by our culture. A salute of three rifle volleys for deceased veterans at their graveside, how we do funerals, eulogies. You know, in terms of the deaths, tossing a handful of dirt on the grave, cards that we send or receive. All these things reflect this behavioral expression of grief, which is that mourning. It’s what we share with other people. So we’ve got loss. Actual loss, that’s the loss of the actual good. Potential loss, that is what will no longer be because of the loss. We’ve got grief. It’s got those psychological, it’s got those physical, it’s got those emotional, it’s got those behavioral components to it. And mourning, mourning is our public expression of grief. It’s what we show others. We got all of those. But how can we really solidify our understanding of these definitions? How can we really make these concepts come alive? Well, let me think. Let me think here. I’ve got it.

[00:09:12] How about a story? How about a story to have all of these things come together for us? How about a story to illustrate all this for us? I think that’s a great idea. So it’s story time with Dr. Peter. All right. We’re going to go back 20 years for Richard and Susan. These are made up people. This is a story. This isn’t an actual case. But we’re going to go back 20 years back to the early 2000s. And at that point, Richard and Susan had been married for eight years. Richard was an engineer, excellent job, highly successful, creative at work. He really loved their three young sons, sons aged seven, five, three. Susan was a professional translator in Spanish and Italian. She had traveled and lived abroad before her marriage at age 32. They met through mutual friends. Both were nominally Catholic. Both attended Mass on Sundays and their sons were baptized. But it wasn’t a central part of their lives. Richard was somewhat emotionally reserved, kind of introverted, didn’t talk a lot about his feelings, and he had always been into racing go karts. Now the oldest son, seven years old, time to get him into it. They love the hobby together. Little son’s got a mini go kart. They’re really enjoying it. Susan, more extroverted, maintained a lot of connections with their professional women friends, many of whom were younger than her, many of whom were still unmarried, some still living in Italy and Spain. Susan really wanted a daughter. She’d been going through some recent fertility issues.

[00:10:54] There were medical complications there. Richard felt he had enough kids. He was happy with the sons he had. Age 40, though, after a deepening of her prayer life, Susan began to take her faith much more seriously. She conceived again, and the ultrasound indicated the baby was a girl. She was so excited. 22 weeks. Everything’s going well. And then complications with the placenta started. By 24 weeks, the baby had died. Susan miscarried her baby daughter and because of medical complications, she also wound up with a hysterectomy. All right, so we have a story, or at least the beginning of a story. So let’s work with the story. All right. Remember what we had. We’ve got loss. We got grief. We got mourning. Loss, two kinds of loss. Actual loss, first, right. Actual loss is the loss of a real tangible good. You know, what it is for Susan in the story, right? The loss of the baby herself, the death of the little one. All right. So what was the loss of potential? Remember, the loss of potential is the loss of possibilities that we hope for, something we anticipated in the future. So in this case, Susan’s loss of potential was seeing her baby daughter grow up, hearing her first words, watching her first steps with her at the first day of school, ballet classes, report cards, prom, her wedding to a handsome young man wearing Susan’s own wedding dress, grandchildren. All right. You see it? You get that? But there was also another loss of potential.

[00:12:54] Remember the hysterectomy? Right. This was like a criminal sentence to Susan. No more children. No more chance of a daughter, bone of her bone, flesh of her flesh. Right. So we have an understanding of loss here. The loss is the cold, hard reality. That reality of loss exists outside of Susan’s reaction or her experience. The loss just is. Now let’s shift to grief. Remember, grief is the individual experience of loss with all its physical, emotional, psychological, and behavioral aspects. Let’s dive into grief in a lot more detail. Okay. So many of you probably know that more than two decades ago, University of Chicago psychiatrist Elisabeth Kubler-Ross identified various stages that she said people went through when experiencing grief. She was really focusing on people who were diagnosed with terminal illnesses, people who were dying and their families. I’m going to run through these a little more quickly. The research is mixed on this. These stages do exist. Even Dr. Ross said they don’t always happen in order, but they do give us an idea of the different kinds of experiences of grief that people have. So she said that the first stage of grief was denial, right? This helps us to survive the loss. The world becomes meaningless. We struggle with like, how could this have possibly happened? There’s feelings of being overwhelmed. We may go numb, just sort of shut down. We try to find a way just to survive the experience.

[00:14:33] Denial is actually a gift. It’s a defense. And what it does is it protects us from the intensity and the overwhelming nature of our feelings about the situation. It allows us to sort of to damp down the affect, to damp down the emotions so that we can actually just get through, if there’s shock, disbelief. And this can last a few seconds. This could last a lot longer, right? So denial. This is something that Susan didn’t want to hear. She went in check up at 23 weeks, abdominal pain, some bleeding that she wasn’t comfortable with. She was really anxious about this pregnancy. And then the ultrasound shows that the baby’s not moving. The ultrasound technician is quiet, doesn’t want to answer her questions, refers her to her OB/GYN. He gives her the news and she just struck dumb, silent. Can’t be. This cannot be happening. This cannot be happening. Okay. That’s the experience of denial. That denial comes up in response to the intensity of suffering. This is the stage that many people are in at the time of a funeral, really just a couple of days after the death, usually. So Elisabeth Kubler-Ross afterward said anger comes up. She identified this as a critical component of healing. I’m not so sure about that. I think people have different emotional reactions. Anger may or may not be there, but it is really important that if it is there to be able to address it. And we’re going to talk more about that in upcoming podcast episodes.

[00:16:21] But this is a very common, she would say, universal experience. I would say it’s a very common experience for Catholics. There’s often the sense of, what was happening? Where were you, God? Remember, Susan had been had been growing in her faith life. She had been praying more regularly. She was starting to take it more seriously. Not uncommon when your kids are starting to grow up and you need to be able to form them. She took that seriously. Where is God in all this? And underneath the anger and what drives much of the anger is the intensity of the pain. Next stage for Elisabeth Kubler-Ross, bargaining. Now, this often happens before the loss is fully realized, before the loss of potential. Right. This is where you go back and forth, often bargaining with God about what you would do if the terrible loss doesn’t happen, right? I will pray a rosary every day for her vocation. I’m open to giving up the beautiful wedding with the handsome groom. She could be a nun if you really wanted her to be a nun, Lord. This is the kind of things that you get into when you’re in the bargaining phase. The next phase that Elisabeth Kubler-Ross discusses is depression. Then we move back into the present. Empty feelings come up. There’s this void within. We really struggle with it. We might experience pain on a deeper level than we ever imagined. Sometimes the loss brings up previous losses. They come rushing from the past into the present when they are unresolved.

[00:18:04] It’s a common response to feel that level of sadness and the level of intensity. We’re going to in a future podcast, really go over the difference between a clinical depression and normal grieving. That’s a really important distinction to make. But for right now, what we’re going to say is depression was the fourth stage that Elisabeth Kubler-Ross offered us. And the fifth one was acceptance. All right. Sometimes people get this a little mixed up. They think that acceptance somehow means that they are being all right or okay with what has happened. You know, when you’ve lost a spouse, for example, of 35 or 40 years, that’s more than most people can really do. Right. We’re talking about accepting the reality of the situation and its implications. It doesn’t mean that we necessarily agree with it or that we embrace it, but we learn to live with it. This is the new normal for us, and we accept that. A lot of times it comes in fits and starts. It comes a little at a time, bits and pieces. It’s usually not just one great moment where we say, yes, I accept. This usually takes more time for us to adjust. We can never replace what’s lost. That’s true. But instead of denying our feelings, we really start accepting where we are with them. We start listening to our needs. We start focusing on what is going on inside of us. You might say that we begin life anew.

[00:19:43] We start over at that point. David Kessler brought in a sixth stage of grief. He collaborated with Elisabeth Kubler-Ross, and he actually brought something in that I think is extremely important for us Catholics. And that is finding meaning in the loss, finding meaning in the loss, integrating it with the rest of the narrative of our life in a coherent way. Okay, so we have those stages: denial, anger, bargaining, depression, acceptance. And then the sixth one, finding meaning, making sense out of the experience in a coherent way. So the next thing I want to talk about is four variations of grief, because there’s nothing quite like a death and a funeral to bring out a wide variety of ways that people grieve. Some of them are really mysterious to people, right? Because they’re operating from an entirely different personality organization, an entirely different personality style, an entirely different psychological structure. So we’re going to get into some of these different types of grief and risk and responses, grieving responses. The first one I’m going to talk about is anticipatory grief. This is where the loss hasn’t happened yet, but it’s coming down the pike. We are faced with it. It is coming. As the name implies, this means that we’re anticipating it. It’s got many dimensions. Lots of feelings come with that. Lots of psychological reactions, physical reactions, and behavioral responses. And our Lord gave us an example of this in Luke 19, verses 41 to 44. “And when he drew near and saw the city, he wept over it, saying, ‘Would that even today you knew the things that make for peace, but now they are hid from your eyes. For the days shall come upon you, when your enemies will cast up a bank about you and surround you and hem you in on every side and dash you to the ground, you and your children within you. And they will not leave one stone upon another, because you did not know the time of your visitation.'”

[00:22:08] Anticipatory grief. The grief for what will come. This was part of Susan’s experience when, at week 23 of her pregnancy, trouble was seen with her placenta. It was not looking good. The prognosis was really poor. Anticipatory grief. This is a really important one. This next one, disenfranchized grief. Disenfranchized grief. That occurs when we experience a loss that we can’t really share with other people, that we can’t openly acknowledge when it’s not socially supported. Right. Because then we don’t have the capacity for mourning. This is really common for some women with miscarriages. If we go back to Susan’s experience, remember a lot of her friends, professional women, not yet married, no kids, hard to be able to share the experience of miscarriage for Susan with those folks. And when she brought it to her mother, her mother, who had four miscarriages herself and had never resolved any issues around those for herself, said, yep. That sometimes happens, especially when you’re older. You just have to kind of move on.

[00:23:20] You just have to kind of move on, Susan. Disenfranchized grief. That’s the kind of grief where we can’t share it. This can also happen with, say, gambling, right? Where a spouse has gambled away the family’s resources and the other spouse doesn’t know about it, and the spouse is terrified to say. The spouse is isolated with that grief over what’s happened to the family resources. Disenfranchized grief. Grief that can’t be shared. Complicated grief, that’s a delayed or incomplete adaptation to the loss. In complicated grief, what we’re doing is we’re not coming back to our baseline. Something has disrupted the grieving process. Something has taken it out of its natural course and allowed it to start spinning. Just kind of like it’s an eddy in the in the river of our life. Our life is not moving on. We’re just caught going round and round and round in this eddy near the shore. That’s when you might need some professional help, counselor, a therapist, somebody to actually help you break through that cycle. And we’ll talk more about that in future episodes. The fourth one, unacknowledged grief. All right. This is grief that is suppressed. This is grief that cannot be accepted as real within the person. And there are a number of ways that people can go about being radically affected by grief without them even knowing it. In fact, if you look at psychodynamic formulations of bipolar disorder with the manic episodes, what you see in a manic episode is the exact opposite of what you see when somebody is grieving.

[00:25:18] And the idea behind that psychodynamic formulation is that a manic episode, with all of that intense energy, with all of that goal-directed behavior, with all of that euphoric mood that that bright, that bright, manic mood, all of that is a last ditch effort to prevent oneself from being overwhelmed by grief. So folks that are struggling with manic episodes often have a history of unacknowledged losses, losses that go back to childhood, and they rev up in order to no longer have to cope with the risk of them being totally submerged in grief, because that just seems too threatening. That just seems too unsafe. Another way that people refuse to acknowledge grief is through spiritual bypassing. What is spiritual bypassing? Well, that’s a term introduced in the early 1980s by John Welwood. And spiritual bypassing is the tendency to use spiritual ideas and spiritual practices to sidestep or avoid facing unresolved emotional issues, psychological wounds, and unfinished developmental tasks. We’re dealing with natural, normal human experiences, but instead of confronting them head on within the natural realm, we elevate them to the spiritual realm, and we somehow spiritualize them so that we don’t have to deal with them in the natural realm. And so in that, you could see somebody short-circuiting the whole grieving process by just immediately going to, well, so and so is in heaven with Jesus. And that’s a wonderful thing. And I wouldn’t want any less for that person, without acknowledging anything of the loss, without experiencing the grief.

[00:27:13] In the next two episodes, we’re going to go a lot further into grief, and we’re also going to bring in mourning. Now that we know about what grief is, we’re going to discuss the difference between grief and depression. We’re going to continue with the lives of Richard and Susan. We’re going to bring them up to the present day. We’re going to see how they fared over the last 20 some odd years. And we’re going to discuss factors that interfere with the normal resolution, the normal passing away of grief, and also the things that we can do to help ourselves, the things that we can also do to help others work through grief, bringing in psychological resources, of course, but also bringing in all the gifts of the Catholic faith. All that’s coming up in the next couple of episodes. Okay, so here’s what I’d like you to do. I want you to take the leap. If you haven’t done it already, I want you to register for the Resilient Catholics Carpe Diem community here. It’s free for the first 30 days. You can try it out. No risk. After that, $25 a month. There’s all kinds of extra goodies in there connected with this podcast. Now, on Wednesday, May 27th, I’m going to post a running list of the things that Catholics often grieve. Some of them might be quite unexpected. I’m also inviting community members to add to that list. We’re going to get in a discussion about this. 

[00:28:33] At 7:30 p.m. on Friday, May 29th, we have our first small group Zoom meeting. I’m going to make a brief presentation, and then we’re going to have some questions and answers. And then I’m going to facilitate a discussion of what causes you grief in the present day, in these troubled times. That’s closed, just for community members that are there. We’re going to also put up a recording of it so people can connect with it later, again, foster some discussion. We’re going to start connecting, though, on important topics like grief and what’s happening in the present pandemic that’s increasing grief. We want to get real. We want to get connected. We want to support each other. That’s what Souls and Hearts is all about. That’s what this podcast is all about. That’s what the Resilient Catholics Carpe Diem community is all about. We are real Catholics, overcoming real issues through real transformation with real growth. So come join us at Souls and hearts.com. Check out. Check out the community. You’ll find it there right on the home page. Scroll down if you’re having trouble with it or if you’ve got questions, you’re not sure, you can reach out to me, crisis@soulsandhearts.com. Bring me your questions about the community. See if it’s a good fit for you. All right, so that’s a wrap for today. We’re going to invoke our patroness and our patron. Our Lady, our Mother, Undoer of Knots, pray for us. Saint John the Baptist, pray for us.