Allow for Grief
MEDICAL AND MENTAL HEALTH UPDATE
Let’s talk about loss. Not because it’s sexy or particularly fun but because we have to. We are all experiencing loss. And understanding the process of grief can help us create a roadmap to ease pain—and even find meaning.
While pain comes in varying orders of magnitude, whether you’re losing a loved one to COVID-19 or losing your senior spring of high school, we all are losing important parts of our lives.
Even small things like your Saturday morning yoga class, your regular haircut, your spontaneous spring happy hour with friends—they’ve vanished.
We can’t hug, snuggle, piggy-back ride, leapfrog, close-talk, or slow-dance at prom like we used to.
And it hurts.
We are hurting together—and apart.
The collective trauma of COVID-19 is its own pandemic, and we need to talk about it. Our health and wellbeing depend on it.
GRIEF GROUND RULES: Please know that you’re entitled to grief no matter WHAT you’ve lost. I’ve heard many times from patients this spring, “This seems so silly when you’ve got patients with COVID, but I’m really sad about missing my grandson’s baseball games” or (quite a lot from my older patients) “At my age I can’t stop thinking about all the time I have lost this spring.”
As trauma expert and my new friend Dr. Roxane Cohen Silver would say, “You can’t compare grief across traumas.” (We actually wrote an article together about collective trauma.)
And Roxy (she lets me call her Roxy) is right. There’s no contest on sadness, no loss too small, no lost moment unworthy of mourning. Apologizing for our own grief makes as much sense as apologizing for being human.
Experts agree there are SIX STAGES of grief that most people move through, whether they know it or not. Of course every situation is different, and no one reacts to loss in exactly the same way. But understanding these stages can help us make sense of losses that can feel overwhelming, confusing, and just plain sad.
STAGE 1: DENIAL. Boy, does this come in handy. It’s like nature’s way of buying us time. We are numb. But we’re actually pacing ourselves. We are processing and preparing, too. And as we start to question our new reality, we’re actually moving forward with healing.
STAGE 2: ANGER. Anger is a necessary part of the healing process. It anchors the pain, and expressing it helps diminish it. We often see anger as something to suppress, to shove down, to silence, when actually acknowledging it, feeling it, and working through it is good for our health. Sometimes this stage, like others, requires added support, and grief counselors (and/or your doctor) can help.
STAGE 3: BARGAINING. You’d do anything to have that part of your life, that person, that experience back. We try to negotiate with the pain. Our mind becomes filled with “what ifs” and “if onlys” as we live in the past. Guilt can compound the suffering as we often blame ourselves.
STAGE 4: DEPRESSION. When we start to face our new reality, we enter a state of natural sadness. We can feel lost and overcome with emotion. But this is part of the healing process, too. And while the depression component of grief is normal, it’s important to talk with your doctor about moods—to help distinguish between the natural depression from grief from a true mood disorder. We can help.
STAGE 5: ACCEPTANCE. This is not the same as “being okay.” It means finding peace with the loss, forging new pathways forward, and making sense of a new normal. It’s when we start to listen to our feelings, take care of ourselves again, and have more good days than bad days.
STAGE 6: FINDING MEANING. This is when we notice silver linings, unexpected joy, and new hope. It is not “closure;” but rather it’s about new beginnings and finding peace. It’s the birthplace of hope, strength, and resilience. It’s what some people call “post-traumatic growth” (a term I don’t love because it implies that something is wrong with you if you’re not stronger after loss—and indeed sometimes we AREN’T ANY BETTER OFF.) But if you’re fortunate enough to find meaning, savor it, use it as your rocket fuel, and write it down for when you slip back into other stages.
It’s important to note that these steps are not “requirements” for coping, nor do we enter and leave each stage in order. These stages are responses to natural feelings. And just as feelings can last minutes or hours, we can move in and out of one stage and back into another.
SO! On this chilly spring day (here in DC), we’re looking down the barrel of a very NEW normal. And we’re mourning the loss of our OLD normal, warts and all. School, work, and social life will invariably be different in the future. How will that look? And how will we FEEL?
I, myself, miss a lot of things. In particular, I LONG for my Saturday walks with Courtney, my Tuesday morning yoga class in my kitchen with neighbors and Alice, browsing at Ella Rue, deal-hunting at TJ Maxx, and simply being with my patients in person. I miss traveling. I miss eating out. I miss kiss-kissing and laughing at loud, crowded parties wearing high heels—and regretting it later. I miss hugging my parents and brothers and nieces.
Will it ever come back?
I have hope. We’re getting smarter about this virus every day. Vaccine trials are underway. People who are following the rules (see Tuesday's post) are not getting sick and not infecting others. And, thus far, ALL of my patients who’ve recovered from COVID-19 have tested positive for antibodies (suggesting, but not proving, immunity). They can even donate plasma by clicking here! People are looking out for other people. Kindness is in fashion. My kids did the dishes tonight.
ONWARD!
This WILL be over. We WILL be back to normal—even if it looks different. Change is hard, but change can be healthy, too. Let’s breathe, be patient, and know that the universe has our back.
I will see you tomorrow with a report from the FRONT LINE: my interview with friend and colleague Jen Abele, MD, Chief Medical Officer and ER physician at Sibley Memorial Hospital. She has some great info to share with you! Until then, be well.
P.S. Tomorrow join me and BBC’s Katty Kay on Instagram Live at 11:15 am EST for a news roundup!
P.P.S. Yesterday I interviewed my colleague, friend, and medical partner Dr. Clay Ackerly. He’s an internal medicine doctor and geriatrician—and a generally wonderful human being. We discussed the unique challenges of our older patients, AGE (and its relativity), and assessing our unique risks during the pandemic. We had great fun, bloopers and all! If you missed it, check it out here!