When someone we love is suffering

The problem with loving someone—there are many but let’s start with this one—is that sometimes the person you love will suffer. They will have pain or disease or grief or distress and you will not be able to magically take it away from them. Watching someone you love suffer, physically or emotionally, is awful. And yet, it’s part of the whole deal.

Once, after my mom died, I told a colleague, “I just don’t want my brother and my dad to be sad.” I ended up laughing instead of crying because of the way my sweet colleague stared at me and said, “Elizabeth.” It was, in fact, a bonkers thing to say. It was also true. My own grief was hard enough to bear; I couldn’t stand that the people I love were also suffering.

This is a common theme for my clients, whether they are caretakers or bereaved. Their own grief is awful, all-consuming, exhausting; and yet, they cannot bear to think that other people in their life are also having a hard time. Ignoring the grief and pain of others is doable but doesn’t feel great and also can be hurtful to said loved ones. On the other hand, taking on the pain of others also feels awful and doesn’t take anyone’s pain away. So what to do?

The answer, of course, depends: on what kind of day you’re having; on how the relationship usually functions; and on the cues you’re getting from the other person or people. But in general, as I’ve written ad nauseum, our grief is much easier to bear if it’s shared. You are not protecting your loved ones if you deny your grief or theirs. On the contrary, talking about it opens the door gives them permission to grieve with you instead of protecting you.

We don’t want the people we love to suffer but they will; that’s a part of life. And if that’s true, we may as well suffer together.

Say no: Setting boundaries when you're grieving

Therapists love to talk about boundaries and I am no exception. Boundaries are wonderful! There are so few things we can control in our lives; setting limits with others is one of them. That being said, knowing we can make our own rules in this way is easier than actually doing it.

Setting boundaries can be frustrating, to say the least. That’s because most frequently, the response you get from others when you set a limit with them is not ideal. It is not, “oh, thank you for telling me! I will honor your request with good humor!” Instead, setting a boundary or a limit with someone in your life often leads to hurt feelings and frustration. Asking someone to give you space or not bring up a certain topic or whatever can be difficult for a number of reasons: you’ve never said no before; or the situation has been the same for so long, it seems weird to suddenly ask for a change. Likewise, the person who is being asked to step back or stop a behavior often feels defensive: what’s wrong with the way things are? Why are you suddenly changing the game on me?

But life is always changing (which is out of our control) and we need to be able to make changes that suit us (which is in our control). This is especially true when we are grieving.

Grief is exhausting. It takes up so much of our energy, mentally, physically, and emotionally. In a grieving period, we need to be able to tell others (who may be well meaning) what we need. Most often, what we need during our grief is to say no.

I don’t mean you should hide away in a cave until you feel better (though there may be days when that sounds appealing). Rather, I mean you don’t have to go on as if everything is normal. It isn’t, for you. Your life has changed and you need time to adjust and figure out how you want to move forward. People in your life may not understand this; they may want you to show up in the ways you used to, at work, in your family, in your social life. I’m giving you permission to sometimes say no, without guilt. Your grief deserves your full attention. You deserve to honor it by asking for what you need.

Grief before loss: Anticipatory grief

Most of the time, we think about grief in terms of a death loss. After a death, your grief may be all consuming but it’s also clear: someone you love is physically gone and their absence is painful. But sometimes we lose someone before their body dies. That grief—the more ambiguous, murky loss of loving someone who leaves us by degrees—is called anticipatory grief.

Just as it sounds, it’s the anticipation of a loss before the loss itself. Perhaps the person you love is still physically present but they’ve had a major change in their functioning. I don’t just mean dementia, although that has its own devastation. It can also be that your loved one has cancer or ALS or some other illness that is changing their mind and body over months or years. It can be that you’ve lost the person you knew to their addiction or a traumatic brain injury that’s changed their personality. The person you love is technically alive but they aren’t themselves anymore.

In some ways, anticipatory grief is even more difficult to deal with than the grief that follows a death. When someone dies, there is a clear date to point to as the “beginning” of your grief. There are milestones to mark: one month without them, six months, a year. When your loved one slowly leaves you, it’s harder to name your grief and figure out how to cope with it.

That naming is the first step. Acknowledging anticipatory grief will help you move through it. Remember, we don’t “get over” grief, no matter what kind it is; instead we learn to grow around it. Rather than trying to ignore it or avoid it, speak it aloud; share it with others; carve out the space and time to honor it. Anticipatory grief is normal, even if it’s hard to wrap your mind around, and it deserves your attention. Reach out for support; you don’t have to do this alone.

How to talk to someone who is grieving

The prevailing reaction from people when I tell them what I do for a living is, “ugh, how do you do that?” Which, I get: listening to people talk about their grief all day sounds like it would be depressing. It certainly can be at times. But it’s also an honor to hear people’s love stories, which is what grief pretty much amounts to: ongoing love for someone who has left us.

That being said, I realize not everyone feels the same comfort when talking about death, grief, and loss. So if you aren’t a grief therapist, what on earth are you supposed to say to someone who is grieving?

First, let me release you from the idea that you are capable of curing someone else’s grief. You are not. Grief does not have a cure, nor does it have an expiration date. This is not to say you should throw up your hands in despair and ignore someone else’s grief entirely. Rather, I want you to let go of the idea that you are responsible for fixing someone’s grief by knowing the exact right words to use on them. There are no exact right words.

There are, however, some less right words. By this, I mostly mean stay away from cliches like “she’s in a better place” or “it’ll be ok.” I know those phrases are tempting to use; they’ve become cliche for a reason after all. But that doesn’t mean they’re particularly helpful. You may sincerely believe in your heart that someone is “in a better place” but you don’t have to say that out loud to the bereaved. Likewise, you don’t have to say that “everything is going to be ok” or that “they wouldn’t want you to be sad.” Again, those things may be true but they aren’t useful to someone who is grieving a loss.

What is useful for grievers is to be truly heard. This means listening without trying to come up with an answer. You aren’t fully listening if part of your brain is working on a response. There’s also no rush to reply immediately with a profound and heartfelt speech. “That sounds so hard,” is enough. Or, “I wish you didn’t have to go through this.” Both of those statements convey that you hear what the bereaved is saying and that you aren’t going to try to convince them of anything. You’re just going to let them be sad. And if they’ve said something that you really don’t know how to respond to, admit that! “I don’t know what to say” or “I don’t know how to help” are both completely reasonable responses to someone’s grief. Sometimes there are no words.

That doesn’t mean we are powerless to help. When someone is grieving, even if you can’t think of the right thing to say, you can sit beside them and help shoulder their burden for a little while. That, I think, is far better than talking.

The Grief Wishlist

When my mother was dying, I was pregnant with my first baby. As you can imagine, there were a lot of complicated feelings swirling around: joy and relief (it was a process for me to get pregnant; this was a very wanted kid) mixed with grief and anxiety and also hope that my mom would be alive when the baby came. As close as we were, it was almost impossible for us to talk about the idea of her dying before I became a mother. Mostly we didn’t talk about it at all. Then one day she suggested that I write down a list of questions for her about babies and she would write down the answers. Just in case.

I never did it.

Not because I didn’t want her answers; I wish I could go back in time and write down a hundred questions for her. But at the time I didn’t know what to ask and honestly, I didn’t want to admit to her or to myself that she wouldn’t be with me when I had the baby.

I wish I had written down something.

I’m sharing this story because it is typical of grief. “I wish” can be followed by any number of should have’s or could have’s, if we had only known that the person in question was going to die. I hear it from my clients: “I wish we had spent more time together” or “I wish I was more patient.” The grief wishlist can be unending if we let it be. There is always some regret when we lose someone we love.

The question is, what to do with those feelings? When I hear my clients say they wish they hadn’t spoken sharply to their loved one, or they wish they had been more present, I don’t wave it away and say it doesn’t matter. Instead, we sit together with the sadness and the regret and the guilt. We acknowledge all the things that can’t be fixed or changed once someone is dead. We talk about what the wish really means, which is usually, “I miss this person. I want them back. I wish they hadn’t died.”

Feeling our grief is the only way through it. When you find yourself saying, “I wish” or “I should have,” don’t run from that feeling. Tell someone you trust (ahem, like a therapist!). Write it down. Acknowledge that your grief is complicated and nuanced. Consider your grief wishlist as a tender, loving tribute to the person you miss. Personally, when my grief wishlist feels heavy, I talk out loud to my mom. It’s a private conversation so I won’t share it with you but I will tell you that doing that helps me. There’s something that will help you too; you just have to find it.

The pain and comfort of shared grief

This is not what I wanted to write about today. In fact, I had started a totally different post yesterday. But this morning, whatever I had written before seemed pointless in the face of yet another senseless tragedy.

When a tragedy occurs—a mass shooting, for instance, or a racist murder—we experience grief, even if we haven’t been directly impacted. I don’t personally know anyone who was killed yesterday in Texas, or in any of the other violent tragedies that have taken place over the last several years, but last night I found myself crying in my husband’s arms, thinking about the devastation of those families and communities.

I’m not a big fan of the five stages of grief (the most commonly cited and probably most poorly understood theory of grief but that’s a discussion for another day). Despite my rejection of the five stage model, those first three stages describe my feelings at the moment: stage one, denial (this cannot have happened again); stage two, anger (why does this keep happening, what is everyone doing, someone should DO SOMETHING); and stage three, fear (we are not safe. My children are not safe).

I am rattling around between these three stages, both drawn to the news and social media and also wanting to hide from it. I want to talk about it at length with others but also can’t bring myself to discuss it out loud. I am alternately disbelieving, furious, and terrified. I want to do something useful but also feel paralyzed and useless. I am, in short, experiencing grief.

I know I’m not alone. So many of us who are parents talk about holding our babies close after this kind of event and that’s certainly something I did last night: I watched my children sleeping peacefully and thanked God they were safe. In my sadness and fear, I imagined parents all over the country doing the same thing. And I imagined all of us reaching out to hold each other up, clasping our hands together and sitting with the enormity of this tragedy and all the others that preceded it.

When something does not directly impact us, it can be easy to turn away from it (denial again, right? “That will never happen to me, ignore ignore ignore”). And there can be some turning away: we cannot sit only with pain all day, every day. But there can also be some turning toward each other. We can grieve together. We can hold space for each other in moments like this, acknowledging that witnessing suffering and tragedy is nearly as bad as experiencing it for ourselves. We can call what we are experiencing grief, even if it is not our personal loss to bear. We can be still in this moment and feel the wave of anguish, of anger, of fear. It won’t swallow us if we hold on to each other. It brings me a measure of peace to believe this; I hope it does for you as well.

How to Mark the Anniversary of a Death

I have never found the right word or phrase to describe the date of someone’s death. Anniversary sounds like something to celebrate; death day sounds flippant for some reason. Still, I can’t think of another way to say it so we’re going to stick with anniversary, which is technically what it is: an annual marker of an important date. And anyway, whatever you call it, the date of a loss is important and needs to be acknowledged.

A lot of people hang on to the idea that after that first anniversary passes, they will somehow be on the other side of grief. And although it’s true that time heals, there is no “other side” to grief. Which is not to say it never gets better; of course it does. But it doesn’t end. You don’t get to the other side so much as enter a new phase of grief. During holidays or birthdays or death anniversaries, our grief can grow again. As I've written before you haven’t had a setback when you feel your grief. Rather, you are continuing to experience normal, typical, regular grief. It ebbs and flows, like the tides.

Paths, tides, other sides: forgive my tortured metaphors. Let’s get more concrete: how should you mark the anniversary of a death?

The short answer is: however you like.

The longer answer is: it depends.

It depends on what will make you feel… not better, but comforted. What will make you feel that the day can pass without you white-knuckling through it? For some, the routine of every other day is paramount. I’m not recommending you ignore the day, but if it brings comfort and solace to get up and do your normal stuff, then that’s what you should do. For others, the day needs to be honored and ritualized and marked somehow. In my family, one of us texts the group chat with the number of years that have passed. It’s a small thing, but it helps to remember that we have suffered our losses together; that we are not alone in our grief. It’s a ritual, albeit a small one.

That’s the thing about rituals: they don’t have to be epic. You can choose to mark the day in a small, quiet, safe way. In fact, that may be the only way you can mark it. You can also choose something big and loud and intense. Your mileage may vary, as they say on the internet.

What’s important is that you figure out what works for you. There are no rules to grief and there are no rules about how to mark a death day. But I encourage you to mark it in some way: to write a note, share a photo, text or call someone you love who remembers. Tell a favorite story, take a walk in the woods, speak out loud to your person. Perform an act of service, sing a song, cry in public or in private. Find the thing that makes the day go by. Because it will go by. More days will come, some better and some worse. And on the worse days, I encourage you to lean in; let yourself feel. The only way out is through.

The 6 month grief slump

“Shouldn’t I be further along now?”

This is a common question from the bereaved: however much time has passed, they wonder if it’s been long enough. The implied concern is, am I moving in the right direction? Will I get out of this? There is a fear of being forever stuck in the beginning, acute phase of grief. Additionally, there is a general idea that grief is a path you walk from the beginning (your loss) to the end (feeling “better”). But grief isn’t a straight line; it’s ocean waves. It’s peaks and valleys. It’s never gone; it only changes, from sometimes sharp to sometimes dull. And sometimes the wave or the valley or the sharpness can be unpredictable.

For a lot of grievers, the six month slump is one of the unpredictable times. The first round of holidays after a death or the first birthday without someone are expected to be tough. But around 6 months, a lot of people are shocked by a sudden wave of grief. It feels like a setback. For awhile there, they were feeling like things were getting back to normal: the funeral is over, they’re back to a routine, they are beginning to see what their new life is like. When their grief confronts them again, it is destabilizing. They feel they’ve gotten off track somehow.

But grief is not on a track, or a timeline, or a calendar. It is an experience that changes over time. We learn how to grow around and with our grief instead of trying to get away from it. The six month slump isn’t going backwards; it’s part of the process. Remember, you’ve been here before and you know the only way out is through.

The Fragility of Hope

Sometimes my clients tell me, explicitly or implicitly, that they don't believe they will ever feel better. They are almost entirely without hope. They cannot imagine that their current circumstances will ever change. As their therapist, I want to validate that feeling because it is a real fear. But I also want to help them envision a future without the pain they’re currently experiencing. This doesn’t mean meeting them with platitudes or promises; it means meeting them in their despair and offering them a little light. When they can’t see the possibility of something better, I tell them that I can. Sometimes, I hold the hope for them until they can hold it themselves.

One wonderful perk of seeing a therapist is that the relationship between you is part of the work. You may not believe in your ability to change, but your therapist does. The moment you show up to therapy, you have taken a step towards feeling better, even if better looks or feels really far away.

This is not to say getting there is an easy or pleasant process; it’s often really difficult. But that’s the other great news about therapy! You have to do the work, sure, but not alone: your therapist can help you share the burden. And if you feel stuck in your suffering, your therapist can hold the hope that things will change; that you can change.

If you are struggling or despairing or feeling lost, please know that you are truly not alone. Someone is out there, waiting to hold on to hope for you until it is in your reach again. Just step forward and ask.

"I shouldn't complain; it could always be worse"

There are many phrases I would like to strike from the English language but these two, which are often coupled together, are currently at the top of my list: “I shouldn’t complain; it could always be worse.”

Now listen: I’m not here to deprive you of a helpful coping mechanism. If taking perspective works for you in times of crisis, have at it! But let me challenge you a little by asking you if it really does help.

Sometimes clients say this (or some version of it) because they are tired of having difficult feelings. Their problems begin to feel endless and frustrating; they are stuck. They aren’t looking for perspective so much as minimizing their own experience out of guilt and frustration. Specifically, in a time like this, when the world is full of worst case scenario stories, people are more likely to feel bad about “complaining.” When the news is full of the horrors of war, there is a tendency to minimize our own tough stuff. After all, if you’re safe in your home, with your relative comforts, it’s easy to feel guilty for feeling bad about anything. Of course things could be worse.

But they could also be better. Others’ suffering does not alleviate our own. There is no comparison chart that shows us when we are allowed to complain. Certainly you can count your blessings; in fact, there’s a significant body of research that posits that beginning the day with a gratitude exercise improves your mood. That’s great news! But still, even if you practice gratitude, you are allowed your own moments of sadness; of disappointment; of regret and complaints. You are allowed to experience your feelings without qualifying them with “it could be worse.” You can acknowledge the suffering of the wider world while also making space for your own little corner of grief. I’ll sit there with you until it gets better.

The grief "to don't" list

After a death, people seem to think that there’s a grief checklist, a list of tasks to accomplish that lead to your grief being over. The person dies, you have a funeral, you’re sad for awhile, then you have to “move on,” whatever that means. Sometimes well-meaning family and friends decide that it’s time to help move things along. They start asking, “when are you going to donate all those clothes?” or, “don’t you think it’s time to get rid of the reading glasses?” They want you to rid yourself of the physical reminders of what you have lost as if that will help you “move on.”

Great news, though: you don’t have to get rid of anything. The people who are telling you this don’t understand that the clothes and the pictures and the glasses aren’t preventing you from getting over your loss. For some of us, keeping those things around is like having an anchor. There’s a reason we have cemeteries and shrines and altars to the dead: we want something physical to go to, to be near, to hold, so we can grieve.

After my mom died, a pair of her slippers stayed by the door for like, four years. I could not bear to move them. She had left them there, thinking she would be back to slip them on when it was cold in the house. She had touched them; that made them sacred. After awhile, the spell was broken and they were put to use by other feet. I can’t tell you why it changed; it just did.

This is all to say, there’s no rush to get rid of the stuff. You are not stuck in your grief if you aren’t ready to clean out the closet or put away the pictures or take off your wedding ring. On the contrary, you are moving through your grief by experiencing it. Some well-meaning (but very wrong) person may soon ask, “when are you going to get rid of all this stuff?” When they do, you can answer, “when it’s time.”

Carrying the weight of grief

Grief brings its own kind of exhaustion. Clients often tell me that they think they’re getting enough sleep—they’re going to bed at a reasonable hour and sleeping through until the morning, minus the usual up-to-pee-at-3-in-the-morning—and yet they still feel tired all the time. Why is that, they want to know? Often it’s the weight of their grief, holding them down even as they try to move through the day.

I’m no somatic therapy expert but it’s widely accepted that our feelings show up in our bodies. It’s no coincidence that we describe being “gutted” or “broken-hearted” when something upsetting happens; we often feel emotional pain in a physical way. We cannot disconnect our minds and our bodies, no matter how we sometimes try.

Just like any other heartbreak, grief can show up physically: as exhaustion for instance, or a general achiness throughout the body. Sometimes you may cry so hard you become short of breath for a minute. We cannot ignore the physical pain and weight that grief exerts on us. So if you feel tired, headachy, occasionally short of breath, certainly check in with your primary doctor first. But after you get the all-clear, spend some time considering: is carrying the weight of your grief hurting you?

This is not to say you’re doing grief wrong. All the ways you grief manifests are normal, if awful. Rather, I hope you take away that if you are suffering, you are not alone. No one can take your pain away from you but others are willing to help you carry it. There is no burden you have to shoulder alone, even (especially) your grief. This is your invitation to reach out—to a friend, a lover, a stranger, a therapist—and let someone else share the weight with you.

Now what? moving on when things change

Most often, I’ve written about grief as it relates to the death of a loved one. But grief isn’t only related to death and dying. In fact, it’s one of the most pervasive and universal experiences we share as human beings. It’s a part of the life cycle: relationships and jobs and the stages of childhood all come to an end. Life is full of changes that feel like losses and those losses have to be grieved.

As I’ve said before, I’m a real hit at cocktail parties when I tell people that I specialize in grief and loss. For most people, my work sounds deeply sad. And it can be! As I’m fond of saying, hard feelings are hard. But looked at another way—I live to reframe things, it’s the only part of CBT that I’m truly confident in—it’s a gift to honor our grief when something ends. We can experience our grief without wallowing; we can honor endings without big rituals. We can choose to acknowledge that endings are hard without staying stuck in the hard part.

So how do we do that? There are tons of sort of pop psychology buzz words people throw around, memes on social media meant to inspire, about “closure” and “closing the chapter” and “rising from the ashes.” Those are all lovely sentiments and I don’t disagree with them. But I think we lose the nuance of the grieving process when we put it into that kind of phraseology. Closure, for instance, isn’t a thing. Our lives are not actually laid out in neat chapters that resolve after X number of pages. We never leave behind the people we were, even if we make dramatic changes or dramatic changes happen to us. Instead, we add layers and learn lessons and yes, move forward. In short, like any kind of grief, the only way out is through.

"I'm lonely but I also want to be alone"

A common theme for my recently bereaved clients is an overwhelming ambivalence about being around others. They’re lonely but at the same time, they’re avoiding phone calls and visits from their well-meaning friends and family. They can’t bridge these two feelings of abject loneliness and also real resistance to being around other people; they’re stuck in ambivalence.

Ambivalence is uncomfortable. We’ve all been in that space and you just can’t stay there for long; it feels too bad. I have to borrow from the late, brilliant Stephen Sondheim here for an accurate description: “Sometimes I stand in the middle of the floor, not going left, not going right… am I losing my mind?” Ambivalence is like being paralyzed. How do you move out of it when you just feel stuck?

The answer, as usual, comes with more questions. Sometimes this conversation about being alone but being lonely but not being up for socializing but feeling isolated … leads to this: “which feels worse?” It can depend on the day! Sometimes answering the phone feels like climbing a mountain. Other days, the thought of spending another hour alone in a quiet house is the more daunting choice. Investigating our ambivalence is the ticket out of it. There is always a stronger pull in one direction or another if we allow ourselves to really sit with our feelings.

As with all parts of grieving, your mileage may vary. There will be days when being alone feels horrifying. On those days, use your energy reserve to reach out to someone. Likewise, there will be days when the mere thought of being with others feels exhausting. On those days, you have my permission to relish in your loneliness. Whichever choice you make, loneliness or connection, remember that it is just how you feel right now; it’s not permanent. You only have to get through the next day, the next hour, the next minute. The ambivalence of grief will ebb and flow, like all the other grief feelings. Give yourself the gift of waiting it out. Relief is coming; it may be beyond you right this second but any minute it will be within your grasp. Hang tight.