Tag Archives: grief

family, chaplaincy, duchenne

“Coping” as a couple

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I like this photo, because it was taken in a good moment. I can’t even say, a good day, because our ebbing and flowing these days does not even happen on a daily basis. I am constantly reminded that the photos we take and the posts we make are often made when we are at least good enough to reach out to the outside world. They are only part of the picture though, for me, for Kat, and I would assume for any of us. I can demonstrate some strength, Kat can offer some wisdom and insight… but that’s on the good days… I mean, in the good moments.

On the bad days In the bad moments, it is a nightmare for us. Kat’s need for emotional expression and care clashing with my need to have space, to do, and to NOT talk. There is a chasm there, enough for either of us to wonder (Kat out loud and me inside), is our marriage going to make it?!? More of this later… and note that I wouldn’t go as far as to really believe that there is good/bad in the difficulty of “coping” as a couple, but the shoe fits. What I can say is, it is agonizingly hard. I never thought I would say, “Fuck you!” to anyone, let alone my own wife. And I never imagined that work would be used so often in my marriage relationship. Well, the woman that Life sent my way to love (and to duke it out with) for all my days, or hers, was a glorious surprise and yes, we swear… these days, often. Life did not see fit to give either of us a life of daffodils and moonbeams, and this is our lot. But damn,  we love us some good flowers and a good full moon. We know, though, that we only love the flowers so much because we know that one day, they will not be. And we only love that moon so much because we know that it will wane and grow dark.

41s6e7oy8yl-_sx331_bo1204203200_“Coping” is used so much in the hospital, in therapy, in chaplaincy-talk and I don’t like it. It smacks of “getting by” or something passive that happens as a result of stress that we may or may not be able to make a conscious choice about. I like the term “adaptive strategies” rather than coping skills, as adapting and strategizing are active and intentional. I steal the term from Kenneth Doka and Terry Martin from a book that they wrote entitled Grieving Beyond Gender: Understanding the Ways Men and Women Mourn. I use this resource extensively and it has been so very helpful in my work with grief groups and supporting those in the hospital and in my spiritual direction sessions. Doka and Martin’s way of framing grief styles has given me the awareness that Kat and I, in all of our shitty annoying processes, are not better or worse in how we grieve, we are just different.

Without divulging their entire theory and getting into too many spoilers, Doka and Martin assert that grievers exist on a spectrum between intuitive and instrumental grief. Intuitive grievers are affective in their grief, feeling strong and powerful feelings, and needing to vocalize their grief process. Instrumental grievers are doers, needing time and space to process, think, and make meaning of their grief. They have emotions, but they are much less dynamic and vibrant than those of the intuitive. Men and women fall somewhere on this spectrum, tending more towards some blend of the two poles. It is far from gender-prescriptive, but men tend to fall more on the instrumental and women more towards intuitive.

The very distinct benefit of seeing grievers on a continuum is that there is affirmation for a less emotional style of grieving. For years, therapists, chaplains, and grief “specialists” have said that the only way to process grief is to feel all the feelings. Even in chaplaincy residency, I was expected to verbalize feelings, verbalize feelings, verbalize feelings… maybe much more than is within my capacity. There was benefit to it, but I am a chaplain, not Joe Smith who works his blue collar job and fishes and hunts in his free time. Many people, men AND women, are active and cognitive with their grief, even when they are unconscious that it is their grief that they are working through.

Just last night, to give a perfect example, I got home from my final grief group session in this series and said to Kat, “I can’t talk much right now. I need to sit with this last session and decompress from it.” She said a few minutes later, “You can’t really support me in the way I need to be supported, can you?”… because she wanted to vent and feel. My response was, “Well, I support you in many ways, don’t I? Can I be the support for all your feelings? Probably not. No more than you can get up and go to work for me, when I don’t even want to get out of bed. But I have to do that. I have to get my ass going and do it anyway.” So this morning, as I walked out the door at 6:15, I said to my sleeping wife, “Can you go to work for me today?”

“Sure,” she said as she rolled over and went back to sleep.

And this is how we do. It sucks to not get all your needs met from your spouse. But how many people when I ask how they are handling things as a couple (insert “coping”) say, “Not good. Really not good…” They don’t know why, though, that’s the thing. I just want to say, come to my grief group. It will help. Kat and I, as much as it pains us, know that this is just going to hurt. It sucks. It really fucking sucks. But we do the best we can. In our worst moments, we can’t even talk to each other. In our best moments, we hold each other. And most days somewhere in between, we ask all the unanswerable questions, swear cry and talk, and at least sit next to each other on the couch while we are on our smart phones.

chaplaincy, dying

Why is it so difficult to die?

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I wish this were an easy answer, but unfortunately there are countless reasons why people have so much trouble dying. There are a few things that I am fairly certain about and that I have found that resonate with patients and family members. More often than not I find that people really DO have a difficulty with dying. Whether it be fear, denial, anxiety, or just avoidance, there is an underlying difficulty with dying.

Many people aren’t so much afraid of being dead, as they are of dying. I say this with intention, and I offer this to patients, in order to make a distinction. I have read in numerous places that it is best to think of living until we are dead. If we don’t then we could get depressed or think that our life is over as soon as we admit to dying. Think about it this way. “Dying,” an active tense word, is very different from the words like “dead” (adjective) and “be killed” (passive tense). There is no passive tense of “dying.” It is active, and so there for something we DO. It is something we live in, participate in, and include others in. So how do people want to go about their dying time? This is a good question to ask of people and to reflect on ourselves. We don’t just live until we are dead. These are the people who want to go out in their sleep or want to end their lives prematurely. There is no active participation in their dying there.

For many, unlike our ancestors, being around death and dying can be a very foreign experience. It used to be that loved ones would die at home attended to by family members in the upstairs bedroom. Now it is so often in a hospital or nursing home behind closed doors. The announcement comes from the RN or the doctor and the family comes in after a person has died. So many are not familiar with the signs of dying. They think a dying person may be on the road to improvement when they wake from days of sleeping and not eating and want to tell stories. These moments of clarity are often part of the dying process. Dying also is a very personal experience, different for each person, and something that each person can only go through once. If a dying person doesn’t share what it is like with their loved ones, they offer little of help to the next generation when it is their turn. But people are afraid of causing too much hardship to their loved ones by talking about it too much.

Dying in the hospital is very difficult because health care professionals are trained to cure, to heal, and to “fix.” In and of itself, this is not a bad thing at all. But when it comes to dying, there is no “fixing.” I have heard doctors say that having a palliative care team meet with a family is “giving up too early.” I have seen many many times doctors and nurses shy away from using the “D word” with families when the writing was clearly on the wall. Many will say a person who is accepting their dying is “giving up” or someone who is feeling sad about saying good bye is “depressed.” Too, too often do doctors trying treatment after treatment until a patient, who wants to die at home ends up unconscious while still hoping along with their family that they are going to “pull through.” Or a patient holds off  going home on hospice because a doctor or social worker feels trying out rehab first might be good, only to die the next day at the nursing home. I tell patients if they want to be an active participant in their dying experience, join hospice while they still have the capacity to choose for themselves.

If we can just begin to see how much death is a part of life. Dying is not a “bad” thing. It is a beautiful, sacred, natural thing. Not to say it is a “good” thing either. It just is. It is part of what happens to all healthy, mature, and connected to the earth beings. Going from living to dead is going around this natural process. As Stephen Jenkinson wonders, “How connected is someone to their life when they have to be told they are dying?”

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chaplaincy, nature

How does one process one’s grief?

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My wife asked me the other day, “How does a person process grief?” You’d think that as a chaplain, walking beside and with those who are grieving, I would have had an answer in that moment. Maybe because it was the last, lingering thought before sleeping and I was further along than she, or maybe because there is just no easy answer to a question like this… it goes to say, I didn’t have anything satisfying to give in return.

Maybe the question didn’t sit with me. How do I process grief? Is this different than asking, how do I grieve? I really don’t think it is a matter of processing grief as much as just grieving. Processing is talking about it, writing about it, thinking about it, sharing it, and moving through it. With processing, though, it is always something outside, something that is different than us.

I grieve every day. I grieve when I am with someone who has lost a loved one. I grieve when I hear someone say, “They didn’t tell me chemo was going to be this way. I should have had the operation.” I grieve when I see the wretched state of political debates, of violence, of abuse of our planet. I grieve so much and often that there is a weight I carry that never goes away. I pray for peace and mercy for our Earth and for the humans and the non-humans who live on it. God have mercy.

And yet, I never wish that I could remain naive of all this. I never wish for this weight to go away. It’s like saying, “Breathing is just too much work. I’d rather not do it for an hour or two.” When we learn how to grieve (not learn how to process grief) we grieve even when we are not conscious we are grieving. We become a person who grieves. There is a compassion and a union that happens there. It is a development of the person, something we have to learn and allow ourselves to grow into. Perhaps we begin by remembering that grief is not a bad thing, and it is not a good thing either, it is just a thing. It is a hard thing, yes, but so is waking up when we have been asleep for too long. It is painful, but so is exercising when our muscles atrophy. Perhaps our grief ability has been atrophied by a world that continues to tell us that grief is a bad thing that must be moved through, processed, and healed from. There is no healing from grief.