>> Good afternoon,
and welcome to... the first of
this year's Psychology Department
Speaker Series. I'm Dr. Frank Connor-- I am the
Psychology department chair. It is my honor to welcome to
our stage, Sheila Schindler. Sheila is a faculty member
and adjunct member in the Psychology department,
teaching Social Work. Sheila has her-- she's a
licensed Master Social Worker. She currently is on
the pediatric team at Hospice of
West Michigan. Sheila received her
Bachelor's degree from MSU, and her Master's
of Social Work is from Western
Michigan University. Sheila. >> Hi, thank you. Well, hi,
welcome! Welcome to "Coping
with Grief and Loss." I'm really happy to be
here to talk to you about this topic. I think it's an
important topic, because, well, it's
a part of life, and I think everybody
in this room will probably experience
grief and loss... once or many times
in your life. I think there's varying
degrees of this experience that we go
through, but the truth is that if you're
human, it's pretty unavoidable. I think the only
way to avoid going through
grief and loss would be to not care
about anybody or anything, and I think that's probably
a pretty bad idea. So, the good news is that there
is a fair amount of research out there that helps
us to understand ways to cope with
grief and loss that will ease the
suffering and pain, and also possibly even
bring about opportunities for good things to
come from the loss. So that's what we'll talk
about this afternoon. We'll look at the research
and what it says, and try to
understand better how to approach
grief and loss in a way that eases
the suffering and pain, and also maybe even
creates opportunities for personal
growth. So I think the
best way to start would be to tell you
about two of the families that I worked
with in my career that really
helped me to see the way we approach
grief and loss can make a big difference
in how we experience it. First, I should probably explain
what I do for a living. I am a pediatric
hospice social worker for Hospice
of Michigan, so this means I work with really
sick kids, and their families, sometimes at
the end of life. And... I also provide
bereavement care for these families,
sometimes for years after the loss
of a child. And I have met so many
incredible families and learned so
much from them. But two of these families
that I thought really helped
to kinda show how the way you cope
with grief and loss can have a pretty big impact
on how you experience it, would be these two
wonderful families that are both very
strong families, fiercely loving,
fiercely protective, but they approached it in
such very different ways that their experiences
were really different. So, okay, the
first family was this fiercely loving,
protective single mom, and she had three
teenage daughters. Her youngest daughter
was very, very sick. And this mom was a fighter--
I mean, she's a single mom-- so were her
daughters. They were 16 and 19, but the
12-year-old was really sick. So what this mom
said to me was, "Even thinking about
the possibility "of my child not making it...
is like giving up on my child. "I won't do it. "I will not talk about
death and dying. "I don't wanna even
think about it. "I'm gonna punch cancer
in the face-- we all are. "We're not
gonna give up. "We're not even gonna let
death in the house, period." So...
so, she-- can you blame her? I mean, she was just this
really tough, strong mom. So one night, her daughter got
really sick and uncomfortable. She was having
trouble breathing. So they
called 911, and the ambulance came and
took her to the hospital, and they put her on oxygen,
and she stabilized. So at that point, the mom
said to her daughters, "Let's go downstairs,
get some food, "we'll come right back
up, right back up, "and then we'll settle
in for the long haul "to fight this through
one more time." And... so they went
down to the cafeteria and they were gone,
oh, 10 minutes? And there could be a lotta
reasons for what happened, but I think sometimes when
very sick people's adrenaline kind of goes down,
they're comfortable, they're at peace,
their body can crash, and I think that's
what happened. So she died, very peacefully,
very quickly. And, um... oh, oh, the family
came back up, maybe 15, 20 minutes after
they had gone downstairs. And the nurse had to
tell them what happened. And it was so painful
and traumatic. They were
distraught. They were angry
at themselves, I think, more
than anything. They felt like they
had let her down. They were angry
at the hospital because the hospital
said she was stable and they had
gone down. And then, they were
angry at each other because there was
some disagreement about going downstairs
to get the food. So, they
separated, and they went different
directions to grieve. And it was so
painful to see that, and I think about
them to this day. Okay. So, around the same time,
around the same time, I had another family,
and this little family was on a farm, and they
had four young children. So, on a farm, it's
very different, right? Like, animals die, people
slaughter animals for food, animals
are born. Death is not something
that's foreign, so this family talked about
death right from the start. They did some
wish trips. They talked about the
possibility that he would-- their 12-year-old
would not get better. They talked about it
with their 4-year-old, 6-year-old,
and 9-year-old, and they were able
to ask questions. They'd had family
photos taken, they had some
wonderful memories, and then when
he got very sick, towards the end
of his life, he was in a hospital bed in
the middle of the living room, and they did his favorite
thing in the world... they made a
camp out. They pitched
a nice tent, and they made a fire
in the fireplace, and they sang songs, and
they roasted marshmallows. And then, as he got
very close to the end, they all crawled into
the bed with him, and they held him
and each other, and they talked to each
other the whole time. And it was
incredibly peaceful. It was still painful,
but it was so peaceful and it bonded
them together. So, okay, how to put
this into words. I mean, it doesn't matter
how strong the family is. I mean, both families were
strong, and protective, and loving, and doing
the best they could... but there was a different
way of coping, right? So, the image that comes to me
is that grief is like a wave... or many waves. It kinda feels like waves,
if you've experienced it. So when that wave
comes at you, if you've ever
played in waves, you know that you can
face a wave, head on, and be ready
to fight it. But if that wave
is big enough, you know, the sand goes
out from under you and you just get tossed,
and it's scary, and you're
battered. It's really an unpleasant exp--
you feel out of control. But if you know
anything about waves, you know that when that wave
kinda hits, comes close, you have the option
of diving right in to the heart
of that wave. And you know how you
still get sloshed around but it's not
battering... and you know that
it's gonna end, so there's this peace
that if you hold on, it will pass. So I kinda see approaching
grief in a healthy way as kinda this-- learning
how these waves work and how to jump into them
and become part of them, rather than getting
completely battered by them. So I hope that
makes sense. What I'd like to do
is start learning about these waves now,
and the first step... the first step,
I think, in doing that is to recognize the
different forms of grief in our lives, and
the prevalence of it. So briefly-- I think some
of you have clickers and I apologize
if you don't. I got my hands on
as many as I could. I think there's about
60 clickers out there, and what I'd
like to do is-- and my students who are
here know I do this a lot. (laughing)
I like getting numbers. I like understanding
what's going on in the room, and figuring out what the
experiences are in this room. If you've never used
the clickers before, I'll talk you
through it. There's only
four questions, and we'll get
kind of a reading on the experiences
in the room. I have two student
volunteers, so if they could
come up quickly. We will do this just the
way they do it in class. So here are
the questions. We're gonna get a sense
for the prevalence of grief and loss
in the room, and then the
intensity, and look at how there's
different levels of intensity. So, who's
my writer? (laughing)
Okay, here you go. And then, I thought
when you pull it off you could maybe-- yep,
maybe it'll stick there. There's four
questions. So, let's look at the
first question here. So the first question,
before you vote-- you can't do it until
I open the voting, but I do wanna say a
quick thing to clarify. Have you ever
experienced the loss of someone very
important to you? Notice it says
"important to you" and not
"close to you," because there's something
called "shadow losses" that I would like
to include here. So for example, if
you've had a miscarriage or maybe a parent
died that you never had a chance to
be close to, or, in my own
personal life, I was born into a family
where my brother died shortly before
I was born, so I grew up in a
family where grief was kind of a big deal,
but I never met him. He was important, but
I wasn't close to him, so I hope that
makes sense. So... turn on your clickers by
hitting the yellow button, and you should
see a welcome. I'm sorry if you
don't have a clicker, but I still think
it'll be interesting to get a reading
on the room. So what I'll do is hit
the green button up here. So "A" is "yes," you've lost
someone very important to you, "B" is "no." Oh, 58...
got a few. 59. Okay. All right,
any thoughts? I have
no idea. This is totally
anonymous. I have no idea what the result
will be, but let's find out. So, 50 said "yes"
and 9 said "no." So 85% of the people
in this room have lost someone
close to you already. So the next
question is-- we're gonna add other
losses in life. We need to be
aware of them in order for us to
cope with them well. So, other losses
in life. Death of a pet. I am a big
animal lover and I know that can
be wildly painful. Another type of loss
could be relationship, a bad breakup,
or divorce. "Sense of safety"
means if you've ever been in an
accident. That kinda ruins your
sense of safety. Suddenly, its fear-inducing
just to get in a car. Or if you've been diagnosed
with a serious illness or if you've been the
victim of a crime, these are all different things
that can create loss in life. So "A" is "yes,"
"B" is "no." If you said "yes" to the first
one, you'll say "yes" again, 'cause this is-- you
have experienced loss of someone
important to you as well as a
different loss, okay? So, here we go. So, okay.
(chuckling) We have 95% of the
people in this room have had a
significant loss, either a person or a
different sort of loss. It's just being
human, right? I mean, it is
part of life. So hopefully if
you are grieving, you don't feel
quite as alone. And if you are not,
you realize this is a very, very
common human experience. Okay, so next, we're
gonna kinda look at-- there's different
intensity level to these grief
experiences. So, I'd like to check
out how people are on their
intensity level. Whoops, I'm pointing
it the wrong way. No. Oh, I have to
click on this. There we go. Okay. So this next poll
is to look at how intense
it is for you. So at the time
of the loss, how would you describe the
intensity of your experience? Unable-- like you had to take
time off school and work. Moderate, yeah, you
could get through a day but you had to leave
and go to your car and cry for
a while. Or you're on no
sleep and no food. Or life is definitely being much
more difficult to get through. And then, mild is--
it's pretty painful but no change in
daily activity. And then, D is,
"I have not had a loss." So, hope that
makes sense. Let's find out. I will
open it up. Wow, that was fast.
(laughing) 57. Okay, so. "A" is very
intense. "B" is moderate,
and that's 30. Okay, so "A" was 15,
"B" is 30, "C" is 11, and then the two people
who have not had a loss. So, 26% of people in here have
had that grief experience where it is all-encompassing,
very intense. One in four. And then, finally,
one more question. This one is
about today... how you are right
this minute. So we're looking at
how many people in here are having the experience
of grief, today, right now, sitting here,
listening to this. But also, kinda paying attention
to if it has changed over time. So how does that
same loss feel now? How would you
describe it? And I will
open it up. Go ahead. Okay, so only one
is "A," very intense. 9 at moderate,
38 at mild, and then 1
at no loss. All right, so I
will X out of that. So hopefully you can
see by these numbers, you're not alone. If you're in here and
you have been grieving... something to notice that, look
at the intensity of grief and how it has shifted
over time for many people. So at first, there were people--
15 said it was so intense that they had trouble
functioning in life, and now that's
down to 1. So 30 went
down to 9, and 11 for mild
went up to 38. So, this is important because
one of the points today is grief doesn't
necessarily go away, especially these
very intense losses. Some grief can
only be carried. Have you heard
that quote? I really
like that. Some grief cannot be fixed,
it doesn't go away, it can only
be carried. So today, we're gonna
talk about how to do that in a healthy way. So here's a little bit of the
research and what it says, and you can see it
kinda falls in line with what
we just saw. "Most bereaved persons
experience intense, "time-limited periods of grief,
20 to 30 minutes at a time," but that
varies, too. So those are the
waves that come. And then, normal--
oh, okay, "normal"-- so you're not abnormal if
this is not your experience. I prefer--
(chuckling) they call it
"complicated grief." So this is less complicated
grief, not normal. But the literature
says "normal grief." Normal grief
appears to occur in about 85% of persons
following a loss, largely subsides
within a year or two. So that is pretty much
what we're looking at with the numbers in
this room as well. So okay, let's start talking
about this experience of grief and learning about it, so
we can cope better with it. First, we'll talk
about what grief is, how it affects us. Then, we'll shift into
actual ways to cope with it, research driven, that
can ease suffering and create possibly
opportunities for personal
growth from this incredibly
painful human experience. So here's our terms, just
so we're on the same page. Bereavement is
the umbrella term for the loss of
a loved one, grief is the internal
experience of the loss, and then, mourning is the
outward expression of the loss. All right. The experience
of grief. So here's the big thing
about this bio, psycho, social, and
spiritual-- when you're talking
about grief, there is definitely a
spiritual piece to it. Most people tend
to think of grief as an emotional
experience, when, in fact, it is
all-encompassing. It involves our
whole beings. I had a mom say to me, she felt
like she was hit by a truck. It's that
physical. And if you think about
how to describe grief... your stomach, right, it feels
like wanting to throw up. There's a tightening
in the throat. there's this ache,
and the need to cry, sometimes feeling like
you can't stop crying. There's aches and pains,
fatigue, irritability, anxiety, the
heart is racing. Maybe a feeling
of unreality. Maybe a feeling
of relief. Many times, there's a feeling
of relief and giggling-- that's okay, too. It's a very confusing
experience. (chuckling) It also affects
us socially. As one mom said, she felt--
she lost her child, and she felt like she had
this letter on her forehead that said,
"I lost a child. "Don't talk to me 'cause
you'll say the wrong thing." So she felt pretty
socially isolated. So it can both
socially isolate people but also bring them
closer to some people who do understand
the experience. And spiritually,
many people go through a lot of questioning as far
as, "Why would God do this? "I thought I was doing
everything right." It can be a very
disorienting experience where people have to
reorient themselves to their
spiritual beliefs. So, I've a study to show you
that's really interesting, and I wanna make
sure you get this because grief is
not just emotional. And this study shows how
physiological it is, how it affects us in
very physical ways. So the first part of the
study focused on acute, like those waves
that come at you. But the second part
of the study is what I really
want you to notice. There's all these different
chronic background disturbances that last weeks
to months. Notice, just for
everyday functioning, there's decreased
concentration, and agitation, inability to
have attention. There's restlessness
and anxiety. Notice, also, all
these system changes-- cardiovascular, endocrine,
which is our hormone system which tends to regulate
mood and behavior, so that's being
affected. And immunologic
changes which means that people
get sick a lot easier. So I think the point to be
taken from this research is grievers, first, they're
not crazy if they're exhausted and sick and
physical. Second, they have to take care
of their physical well-being, as well as their
emotional well-being, because it is so
all-encompassing, not to mention their
spiritual and their social. So, okay.
(laughing) So let's try to
start making sense of this crazy emotional
experience of grief and loss, because it can
be so confusing, and there's all these
stage theories out there. I'm not a big fan
of stage theories because it kind of implies
you're doing it wrong if you don't go
through the stages. And... my favorite-- I do
have a favorite stage theory. it's the
two-stage theory. It is one where you
believe in stages, and then two is when
you actually grieve and go...
"There's no stages. "This is
just chaos! "I don't feel like I'm moving
from one thing to another." So, my favorite
research. Okay, it's weird that my
favorite research in grief, but this is my
favorite research.
(chuckling) This helped me make
a lot of sense of how people progress
through grief, because this was done by a
researcher named Davidson... and what he did was he
tracked 1,200 mourners and he followed them
through a two-year period and recorded
common experiences. He didn't look for
stage 1, 2, 3. He looked for
common experiences, so really just
looking at patterns. So this is the
typical patterns that people who are in
grief will experience. Not for everyone. Everyone goes through these
phases in different ways, but 85% pretty
much go through what he has put into
four phases of bereavement. This is how people get through
the first two to three weeks. So this peak's the most intense
the first two to three weeks of the loss. It's called
"shock and numbness." The number one emotion
at this time is stunned. Just stunned. And then, that is
punctuated by moments of flooding,
intrusive thoughts. You can't
maybe refocus. It's all the person
thinks about is the loss. So notice, it peaks in
intensity right away, and then, again, at the
one year anniversary. People in
this phase... if you are supporting
someone in this phase, you know, the old casserole
thing is a really good idea. They have
time confusion. They have different
kinds of needs that they aren't able
to get for themselves, like food,
sleep, just helping them
make decisions, maybe possibly
making decisions about the
memorial service. It's a very confusing
time where people go from stunned, to overwhelmed,
to feeling numb. So, this is
shock and numbness. Phase two-- this hits right
after shock and numbness. And you can feel all
of these anytime, but this is
when they peak. So we're looking from two
weeks to about four months, that searching and yearning,
that people feel that pain, and they're
moving forward. The hallmark of
this phase is energy, so people
wanna set up. They may be
blogging a lot, they may be setting
up memorials, they may be putting
up scholarship funds, going to support groups,
talking to people. There's lots of support
for them still. So, this is an interesting--
a really interesting thing that Davidson
came up with, that 81% of people in
searching and yearning experience what he called
"bizarre experiences." Okay, bizarre experiences
are having visions of the person who's gone,
hearing their voice, sometimes having things that
feel like the person is close to them and
communicating with them. So for example, this
happened pretty recently. I talked to a mom, and she
had gone for a bike ride. And she was in the woods, and
she stopped just for a minute, and bizarrely these
two butterflies just sorta came
floating by, and sat down on her handle
bar, and looked at her. And she was
very baffled, and then they just
sorta fluttered away. And then,
she realized-- she said as soon as
she realized this, she was so filled
with peace. But the daughter who
had died was a twin and she realized
it was, to her, it felt like both of
these lost children had given her
a message, and that message was
that they were okay. And she had this flood
of peace and calm. So another mom talked about
looking up in the sky, and she saw, literally, her
son's face in the clouds. Not a shape that looked
kinda like him, but his face. So I hear these
things a lot. 81% experience it. Not everybody, but
it's definitely part of this searching, and yearning,
and needing to be close. If you are supporting
someone in this phase, then helping them
not feel crazy, just being present,
reminding them... One of the things
we tend to do is say to people, "Oh,
they're in a better place, "and they're not
suffering anymore." But that kind of implies
they need to let go. Maybe a different question
to ask them is, "When do you feel closest
to their loved one?" And they will tell you,
"When I'm in church." "When I see
a dragonfly." I mean, it's different
for everyone. So it's a very
hard period, but high energy, and
searching and yearning. So okay,
phase three. This is a slog. This is when most of the support
systems have dropped off. Bills still
have to be paid. It goes down
at first, and then peaks right around
the fifth to the ninth month. One woman said to me-- and
I think this sums it up-- she said, "I
don't wanna die, "but I don't care if
I wake up anymore." It's just this
incredible fatigue. If you're supporting
someone in this period, don't forget
about them. A lotta people don't check
in after that fourth month, and this can be one of
the most challenging times because of that. So it's also a period
where the person is trying to reorganize
their life. Things don't make
sense anymore. The person they
loved is gone. Like, one dad--
he used to play music with his son
in a band, and he literally couldn't
play his guitar anymore. He felt like he had
to relearn chords. His fingers just
wouldn't work, and I think that's
kind of a metaphor for what a lot of
people have to do. They have to say, "Okay,
this person is gone, "but the relationship
is still there." The love is
still there. What do I do
with that? So, disorganization,
depression, and disorientation. So finally, here's
the good news. Okay, the vast majority, 85% of
mourners will get to this point. It may occur sooner, but
it peaks, as you can see, as time goes on,
18th to the 24th month. Energy starts to return, people
go out and have a good time and come home and feel guilty
'cause they had a good time. Maybe they woke up and
it wasn't the first thing they thought about
that morning. So reorganization
is coming to a point where the grief
isn't gone, but it's being carried
in a healthy way forward, if that
makes sense. And we'll talk more about
exactly how to do that. So if-- okay, my favorite
research is that phases because it helps give
people some sense of where
they're at, and some understanding
that they're not crazy. If that is sort
of like a road map of how grief goes, the
Tasks of Mourning by Worden are the work...
the work you need to do to get from one
phase to the next. And he talks about accepting
the reality of the loss-- again, not
in order. This could go all
over the place. But to experience
the pain of grief, adjust to the environment in
which the deceased is missing, and find an enduring
connection while going forward. I'd like to just talk about
that second one for a second. So we're not-- the research
helps us ease suffering, but not take
it away. If you feel pain, there
are ways to cope with it that are healthy. There's also ways that
are not so healthy, which we all do, and we'll
talk about that, too. But if you don't feel
pain, that's okay. The research has
changed on this. So some people who
didn't feel pain, there was this big fear that
they would have delayed grief. But newer research
shows that delayed grief doesn't tend to happen
most of the time. If you don't feel pain,
don't feel guilty. You're fine. If you do feel pain,
then the problem comes if it's
overwhelming and you don't have enough
positive coping skills to cope
with it. All right, so we're back
to this, to sum it up. Characteristics
of normal grief-- so most people have
these waves of grief, 20 to 30 minutes that largely
subside in a year or two. Here's where I really
wanna stress... (chuckling) the number one predictor
of normal grief is a social
support system. And this theme comes up
over and over again when you're talking about
healing from trauma, healing
from grief, and tonight-- I'm gonna
put in a little plug-- tonight, over at
Fountain Street Church, maybe you've heard, we're having the
Diversity Learning Series has a wonderful speaker
who is highly respected in the field of social
connection, loneliness, and the impact that it
has on human beings. So, I highly recommend you go
over there tonight, as well, and check
that out. His name is
Cacioppo...? Or Cachee, Caziopp--
I don't know. Cacioppo-- it must be Italian?
>> He is Italian. >> Okay. So, my apologies
to Mr. Cacioppo, if it's not the right way
to say it, but there it is. Normal grief really is
helped by social support. So now, let's talk
about the 15% who maybe don't have
this experience. This doesn't mean
they're weak, okay? This is huge. So people who have that--
the 15% who struggle, here's the hallmarks
of complicated grief. Pervasive sadness. It's constant. There's never
a break. You are sad
all the time. That would be a good time
to get some help. The feelings of
self-loathing. So instead of feeling
like, "I'm bad," you feel like--
or, "I feel bad," you start to feel
like, "I am bad." Self-loathing is
another indication... outside help would
be a good idea. And again, isolation
and social withdrawal-- big factor,
big factor. Suicidal thoughts. So here's the big predictors
of having that 15% of complicated
grief experience... poor social support,
number one, right in there. Multiple life stressors
include things like mental health issues,
maybe an addiction, anxiety,
depression. Previous
life losses, which can accumulate
during a lifetime. So every time you lose
someone in the present, it can bring back
all these memories and emotions and trauma
from a previous loss. And then, the nature
of the loss. So, unfortunat-- some
losses are just traumatic. They may be sudden,
they may be violent, they may be
of a child, or for a child, it
may be of a parent. There can be some sense of
responsibility sometimes, like a parent who
looks away for a minute and the child
wanders into a pool. All of these things
can complicate the experience
of grief, as well. So to put some words on these
different kinds of grief, again, awareness
is huge. Sometimes, we just--
we're in a culture where you're supposed
to be strong, and if you're strong enough,
you don't need help, and you can just
get through it. And people don't wanna hear
about how you're really doing. Suffering is,
like, noble. I mean, notice how
we say people died after a "courageous
battle with cancer." I don't think
suffering is noble. So here's how
suffering looks, that we should
probably acknowledge and be very compassionate with
ourselves and other people for. Traumatic grief, if the
loss is sudden, violent... sometimes, it can come after
a very long, long drawn out-- like, the families I work
with, sometimes their kids are sick for years, and
the illness is punctuated by trips to the hospital
where all hell breaks loose, and they think the
child's gonna die, the crisis passes,
and they go back. So it's this chronic stress
that goes years at a time. Disenfranchised grief... that's grief that
the larger culture-- again, this is about
social support, right? So disenfranchised
would be... maybe somebody's having an
affair and the person dies. Suicide can be something people
don't wanna talk about, they don't
understand it, and people can feel like
that's not something they can
talk about. Abortion, in some cases,
can be this kind of grief. So disenfranchised. Cumulative, we
talked about. It just all accumulates
over a lifetime. And finally,
secondary losses... two forms of
secondary losses. So, say you lose a spouse, then
you also lose a good parent, co-parent, you lose
somebody who mows the lawn and does the
finances, maybe. You lose your
couple friends. There's all these
secondary losses, these layers. And then, there's those
losses of anniversaries and birthdays
and weddings. So, just to be
compassionate to yourself if this is something
that you experience. It's real, and it can make
the experience of grieving a lot more complicated
over time. Okay, so... we all do
this stuff. This is all about
pain, right? It's all about
coping with pain. So... and I think about the
wave when I look at this. "Power over pain" would
be taking that wave on and wanting
to fight it. "Succumbing" would be
overwhelmed by the wave. And then, "escaping" would
be trying to outrun the wave, and I think maybe you can,
if the wave isn't big enough, but over time, these
things can lead to isolation
and more pain. So as long as it's not the
primary pattern of coping, we all do some of this,
but if this is taking over and there's no other way
to cope with the pain, and then it's
time to get help. Okay, wow, so...
(laughing) Here it is. The wave
is coming. How do we
handle it? Let's switch gears
into, "What do we do?" We've learned a
lot about grief, kinda dissected it
a little bit, seen it's a very
common human experience. What do we actually do
to cope in a healthy way that will ease
suffering and create some opportunities
even for personal growth? So here's the three
goals for healing-- continuing bonds,
finding meaning, and telling
your story. We'll go into
each one of these. Continuing bonds. Even our language
to people, kind of... it pressures them to move on,
to detach, to let go, right? It's, "They're
in a better place." "And-- but you have
your other kids." (laughing) "You look so good,
you're doing great!" We don't mean to kinda
cut them off from this but this is
much healthier. The idea is,
"The person's gone, "the relationship
is still there," so it's an adaptive response
to bringing that person into your current life
in a way that is new. A new normal. So, some things you can
do is talk to the person. Not crazy--
talk to them. Visualize
them with you. Think about anniversaries
coming up and plan for them, plan to recognize
that person. The holidays are
coming up, right? So if you
are grieving... that can be a really
challenging period of time. I recommend...
simplify life, draw boundaries around
what you need and want, and take care
of yourself as you bring that person
into your rituals. Maybe put ornaments
on the tree. However you celebrate,
add new rituals. Donate-- like one
family donated-- they lost a
5-year-old, they donated gifts
for 5-year-old kids to Santa Claus
Girls. So you find ways to continue
that bond into the future. Oh, I had this
one young woman who... her sister died and
she carried her picture down the aisle
at her wedding, because she would have
been her maid of honor. I know. So, it was such a beautiful way
to keep her sister with her. Okay. Find meaning. So, this is a quote right
out of the research. "Making sense
of the event "and finding benefits
from the experience "result in a significantly
lower distress "and healthier
outcomes." So there's two big ways
to find meaning. One is called
"intuitive grieving," which is more
going in. That's where you sit
there and you contemplate how things
are going. You try to turn it back into
a world that makes sense, feels safe again, and
where there's a feeling, like, of
belonging. So intuitive grieving
is very introspective. Instrumental grieving
is doing things-- plant a tree, help other
people, make donations, go for a walk
to end cancer. There-- there are--
oh, I had-- oh, this was
a sweet girl. She-- this was a young girl
who loved to give away clothes to kids in need, so they
created Katie's Closet, and they had a room
in the school where any kid who
needed any kind of coat could just go in and
take it for free. So that would be a
way to find meaning. But it results in
significantly lower distress and healthier
outcomes. So, one way to help
you get to this point where you have
continuing bonds and you find
meaning... would be to tell
your story. So this is where expressive
therapies come in. And this means a lot
more than just talking. You can join
a support group. I've got a list
at the end here of all kinds of support
groups you can join, which can be
fabulous, by the way. You can do some
writing, art, music, exercise. Anything that tells the story
and helps you process it. So this is something
called "sand tray work." I do this a lot
with families because all ages seem to like
it, including the parents. It's simply a
tray of sand, and then I dump out this
giant bag of miniatures. So they create
a story. This is created
by a 17-year-old. This was actually
the first young girl that I worked with--
10 years ago. And she...
she hated me. (laughing)
She was mad. My students have
heard this story. She was really
tough to work with. She didn't wanna cry,
she didn't wanna talk, but she would
do art. And so, this is her sand tray
10 days before she died. And how she
explained it was... this is her past,
her childhood. There was a little
treasure chest in that cave and it was being protected
by the wizard and the child. Notice, she is not
connected to the ground. She's in a
separate-- she didn't feel part
of this world anymore. And notice the
present is empty, 'cause she felt like
she was in transition. And then, in the future, she
has this white-winged horse which... I don't know if
it symbolized it to her but, to me, that means
going to heaven, something
peaceful, white. Then, she has kind
of a fearful-- I don't know if you can
tell, that's a skull that that fearful creature
is holding at the end. So she has this barrier,
but if you notice past the barrier,
there's a garden. This kid would never have
told me these things. I don't think she knew
she felt this way, but giving her this expressive
way of putting it down gave her mom
tremendous comfort, because she was able
to see her daughter actually kinda thought there
might be something beyond. And her
daughter, also... that was her book
of writings. She dictated letters
right before she died, to her mom and
her sister, telling them
she was-- so these are the things
that people who are dying need to say
in grief. "Thank you for...
I'm sorry for... "I forgive you for...
I love you, and goodbye." And so, I just
gave her prompts, and she finished
the sentences, and it was
so powerful. We had a volunteer put it
into this decorative book to give to
her family. So she's grieving
her own death, but this applies to
all grief and loss. It's, "Tell the story
in whatever way "is comfortable
to you." And then, here's, hopefully,
those positive things that can come out
of the experience. So we have post traumatic
growth syndrome. This research says that
up to 100% of grievers experience
these things. They just don't
recognize it. So part of finding meaning
is seeing this in life. I'm not saying grief
and loss is a good thing... but good things can
come from grief and loss. So these are some of
the things to watch for as ways to
make meaning. New opportunities-- I've had
families create new businesses to help other families
who are grieving. A mom makes Christmas
ornaments with memorabilia from their child in
the Christmas ornament. Um, new relationships as
well as closer relationships and a connection
to others who are not afraid
to connect. Suffer-- er, increased
sense of one's strength and greater appreciation
for life in general, as well as a deepening
of spiritual life. It doesn't
always happen, and frankly, it
happens in spurts, and it may happen
and then go away, but you can always try to make
meaning and keep it alive. Okay. So I'm going to
start closing up here so we can take
some questions, but I have one
more story. I know, my stories-- my
class tells me this, too-- they're all sad. I'm sorry.
(laughing) But hang
in there. This one is
not all sad. But... Okay, so this dad
sums up everything I want you to take from
this today, in three words. So this was a
really, really sweet, just a very
kind dad. And his daughter was 14,
and had advanced cancer, and been through
all the treatments. But in remission, but then
she had some headaches. And she went into the hospital
to see what was going on. She had
an MRI, which showed that the cancer
had spread to her brain. And it was in such a way
that they weren't even sure she was gonna
make it home. So the hospital recommended
she get a room, and they would make
her comfortable. She wanted
to go home. We asked her
what she wanted, and she just kept saying,
"I wanna go home, "I wanna see
my mom at home, "I wanna see my
sister and my dog." So... here's the
other piece. She would not go home
by ambulance even, because if she died
in the ambulance, they would have
to turn around. This is how
strongly she felt. She was
going home. So we wrapped her in a blanket,
made her comfortable, and they lived
about an hour away. So the nurse and I followed her
as she went towards the home, and the parents
were driving. And they
made it. They tucked
her in. She went to sleep,
she was so happy, her dog next
to her. And the parents said to us,
"Go ahead, go home. "We're all right. "We'll call you if anything
happens, get some sleep." So the nurse and
I headed home, and then called at about
7:00 in the morning. She was still
doin' okay. So at about 10 o'clock
in the morning, the nurse and I went back
up, about an hour away, and we were coming
towards the house, and we heard music,
like really loud music, like ground-shaking
music, 'cause they lived down
this long dirt driveway. And I'm thinkin', "I'm gonna
talk to the neighbors. "That's really rude. "They have no idea what this
family's going through. "This is
not cool." So we finally get
to her house... and okay, the house
was on the right, and the driveway went
straight through, and there was this
big field on the left, and on the right
was this girl and she was wrapped
in a blanket and she was surrounded
by her principal and all the parents
and all her friends, and it was
a mob! It was just
a mob scene. And on the other side
of the driveway was the entire
high school band, and they were
just jamming. I mean, the ground was shaking,
people were dancing. And every now and then, she
would turn to the people around her and shout,
"I love you, guys!" And they would turn around
and shout, "We love you!" And it was just like this
beautiful magical moment. So the dad and mom took
us into the house, and the dad looked
at us and said, "You know, when you
left last night, "I didn't think
I could do this. "I thought, 'I'm not a strong
person, I can't handle this.'" But then, he looked
around and he said, "Now, today, I realize that
even though I'm not strong, "we are strong. "We are
strong." And those are the three
words, right there, because I think
that sums up the importance of
supporting each other. You're not
alone, right? And we saw through
the clickers, it's a wildly common
human experience. There's varying
degrees of intensity, but we all go
through it. Working with people
at the end of life has taught me, there is
nothing more important than our relationships,
and each other, and our communities,
and it's how we heal, and frankly, I think
it's why we're here. So... if you don't feel
strong, that's okay. Reach out, support other people,
and support yourself, tell your story, find meaning,
continue the bonds. We're all in it together
as a community. So, we are
strong. So thank you,
thank you. (applause) >> (indistinct). >> Yeah, I'm happy to
answer any questions, and I'll stay after, too,
if you want, and talk about things that
are maybe more personal. Any questions? I encourage you to reach
out to different support, if you need it. Oh, no? It's kind of a hard thing to
ask questions about, right? It's personal,
but... any-- yes? Kelly.
(chuckling) >> (indistinct).
>> Right? >> How do you deal with
the emotions you feel helping take care
of these people? >> Well, that's
a great-- yeah. I mean, I've struggled
with that question myself. This is an ongoing theme
in social work class, too-- "How do you provide support
and take care of yourself?" Well, at first, I
wasn't so good at it. I had some
nightmares, I cried, but I get to see these
beautiful experiences. I get to see people doing
wildly loving, generous, connected things that help
each other at times of crisis. And I've had families
even take me by the hand and ask me to sit with
them at the funeral in the
family section. I mean, you--
if you... if you can just be present
with people in grief. It's not something we are
often comfortable with. It's scary, because it speaks
to our deepest fears, right? So if you can just know, you
don't have to say anything. Your presence
is so powerful, and the rewards
of that. Like, I don't know if
you've had the experience-- when my dad died, knowing
people were at the funeral made a huge
difference to me. I never woulda
thought. But people came
for me, not him. My people I
worked with. It was
really nice. So being present. The rewards you get
from connecting people with people who are probably
pretty socially isolated. Any other
questions? Yes.
>> How do you handle helping people on
a spiritual level? Like, you know,
people (indistinct) with themselves,
with the world. (indistinct). How do you help them
with that concept, or whatever spiritual
grief they may have while going through
that process? Either, you know, dying, or the
people that are around that, having a loved one or
something like that go through the
process of death? >> I don't
judge anything. I think I ask mostly just a
lot of open-ended questions, and let people search
that out for themselves. I certainly can't
give them the answers. We do have a chaplain
as a part of hospice, at Hospice of Michigan, and
all hospices have a chaplain who is available to, again,
non-judgmentally listen, because people
feel guilty. They have a lotta guilt,
a lot of fear, a lot of anger, and
it can just help to talk it out
with people that-- like sometimes at church,
maybe it's not safe to question
and be angry. Go to someone
who's safe, and it's okay to
have these questions and not know how
it's gonna resolve. Tell the story. That's how you
figure it out. It's just...
healing. There's no
magic wand. It's painful, but many
people do make it to this deeper
spiritual awareness. I did, when
my dad died. I wouldn't be
doing this work if it weren't
for his death. Yeah. >> (indistinct). >> Yeah. >> (indistinct). >> Everybody feels
that, right? (laughing)
That is a very common feeling. >> (indistinct). >> You can
say that. "I don't know if I can
ask you how you're doing. "What can I do
to be helpful? "Do you
wanna talk? "Do you not
wanna talk?" Either way
is fine. So you're putting
it back on her. And honestly, the
most powerful thing I think people can do
is just be present. Just be there. You don't have
to say anything. Like, I tell my class
this, "WAIT, W-A-I-T. "Why Am I
Talking?" Sometimes it's fine
to just say, "Is it okay if I
sit here with you?" Or, "Is it okay
if I mow your lawn?
(laughing) "Make sure you're eating,
help you pay bills, "get the bills
written out?" I mean, there's a
lotta ways to provide either tangible help
or just presence... compassionate
presence is huge. You can't say any-- okay,
I went to a conference with Worden, this guru
on grief and loss, and my question
to him was, "I work with people who
are bereaved all the time. "What do you
want me to know?" And his one piece
of advice was, "If you're trying to put
a Band-Aid on it, stop. "There's no Band-Aid,
and if you try, "you're gonna make the
person probably pull away "because they
are not ready." So, don't try to put
a Band-Aid on it. Just let them tell
you what they need. Any other
questions? Well, thank you...
so much. (applause)
