Ep 9 - What Does Grief Look Like

Grief has so many different forms of expression; it’s not always about crying. Learn to recognise how your and others grief is conveyed.
An interview with Shireen Tresslor, a counsellor with a health psychology background and a long term interest in grief and loss, especially around chronic or terminal disease. 

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Transcript

 Ep 9: What does Grief look like?

Kia Ora and welcome to The Ending Life Well Podcast. This podcast series for carers focuses on advice and practical solutions for carers who have been thrown into the deep end looking after a loved family member or friend in their last days, weeks or months of life. 

Our episode today is What does Grief look like?

Denise
Hi, I'm Denise van Aalst, a senior palliative care nurse and educator at Otago Community Hospice, and today I'll be talking with Shireen Tresslor, a counsellor with a health psychology background and a long term interest in grief and loss, especially around chronic or terminal disease. Hi, Shireen. 

Shireen
Hi, Denise  

Denise
Shireen Thanks for joining us today.

Grief can really take many forms can't it? It can look in different ways for every different person. 

Shireen
It can, and unfortunately, some people have very specific ideas about what grief can look like or what it should look like, and might say some unhelpful things like, ‘Oh, you haven't cried yet?’ or ‘Surely you should be over it by now’. And people can feel like they're not doing it right, that maybe there's a right way or a wrong way to grieve, and be a bit concerned about that. 

Denise
It can feel like that there's some real expectations from society, that we will grieve in certain ways. You're not crying enough – you're crying too much. You can't win, almost it feels like 

Shireen
And to be honest, grief is actually a social thing. We grieve socially. If we think about some very public personalities that have died like Princess Diana, or Shane Warne, most recently in Australia, grief is actually expressed socially. We express grief together, we grieve together, and one of the challenges can be when the people you're grieving with, grieve in different ways.

Denise
So even within a family, you might well find that one person is perhaps really vocal and outgoing about their grief while someone else is much more internal. And that could feel quite a disconnect.

Shireen
People have different ways of coping. Some people want to talk about it and want to know everything and get online and search for things. Some people get angry, and want to fight against it and want a second opinion, or want different kinds of information about it, and some people don't want to talk about it at all.

 Denise
I'm guessing that can cause some extra distress really in families if somebody is expecting your grief to be different.

Shireen
It can and that's at a time when you probably don't need any extra distress, but it can happen. Even just knowing that, that actually things can happen differently and that people can react to things in different ways can be useful.

Denise
Yeah, and I guess alongside that would be the timing – that someone might be grieving now while someone else is almost perhaps just putting it on hold while they're busy doing something, and ‘I'll grieve later’.

Shireen
It can happen at different paces. And also sometimes, I think people might think they've finished grieving, or they might think that they're busy with something else, and therefore not grieving, but the grief might actually be expressed in different ways. So I think one of the things we expect around grief is that people will be sad and people will cry, but that's not always the way grief feels, or is expressed. Some people might feel it more physically, actually. They might feel a tightness in their chest, or they might feel like their body aches, or they're just fatigued or they might feel like they're sleeping too little, or sleeping too much, or eating too little, or eating too much. And all these things are actually part of grieving, even though it might not look like what we expect grief to look like. 

Denise
So really, it is a little bit of compassion for ourselves, and for those around us, because if we're within a family that are grieving an anticipated loss or a loss that's happened, then actually, we need to accept that other people's grief is okay – and so is ours.

Shireen
And to be aware of all those different ways in which we might be expressing it. I have heard people say that they feel like they're going a bit crazy because they're feeling all these feelings, and they don't know exactly what they are, and why they're feeling the way that they're feeling. And again, it could be physical feelings, it could be emotions, like feeling guilty or feeling numb or feeling almost disconnected, like you're almost out of body looking at somebody else's life happening, and you don't feel connected with it. Or not being able to think straight, not being able to make decisions, not being able to remember or take in things that have been said to you. 

When this is happening to a family member it can it can feel a bit frustrating because you don't understand why aren't they able to remember things? Why aren't they able to talk about this thing and make this decision? There are a lot of decisions that have to happen when someone dies, there's a lot of paperwork, there's a lot of organisation, and that can happen at a time when we're actually not doing that very well. 

Denise
It's really reassuring to hear you talk about all those things and to know that that's normal. My mum died nearly 20 years ago and I actually still remember some of those sensations. And as you said, exactly that, that feeling of being disconnected and almost numb, you know, that I wasn't grieving, and that felt wrong, because it felt numb. I should just feel sad. So actually, that's really reassuring that knowing all of these other sensations are just normal and that also is grief.

 Shireen
Yes. And how long that happens for, there's no time limit to that either. Again, something unhelpful that people might hear is, ‘Surely you should be over it by now’. And I think that idea of being over it as well… I'm not quite sure that that actually reflects what reality is. 

I lost a parent. when I was young and I still grieve for my father. You know, there are times in my life, like when I got married or when I had children, that I especially missed him and that grief was particularly triggered there because he wasn't around for those special times and he should have been. The emotional pain that we feel, over time might lessen; the intensity of the feelings that we feel might lessen, but there is no fixed time limit. There are times when grief sits in the background and other things take over, other things are more prominent in our lives. And then there are times when it flows and it feels more raw and more intense and we remember and we grieve again.

Denise
I don't think you ever really get over it, do you? You learn to live with it, rather than stopping grieving.

Shireen
Grief is the price we pay for love. When we love and value something we grieve for it, and finishing grieving implies that the love is finished too. We don't ever stop loving our mothers and our fathers and our brothers and sisters, our children, people that we really love and value in our lives. We don't stop loving them, and so we don't stop grieving their loss. The intensity might change, but we don't stop grieving them. 

Denise
it becomes part of who we are.

Shireen
That's absolutely right. And grief is it's not just an emotion, – it's not just a thing we feel. lt's actually part of a process, and the process is about learning to live with that loss, learning to live with what that loss means to you, how life has changed, all the new things that have come in because of this precious thing that is not there anymore. 

It's also part of recreating a relationship, so our relationships don't end just because someone dies. We still have connection, we still think about them, we still remember them, we still remember their wisdom. We draw on their knowledge and their strength and we continue in relationship with them, but part of that grieving process is recreating that relationship because the form has changed. So grief is a lot of things. It's the way we feel, it's what we express, it's how we remain connected with that person and how we adjust to living with that loss.

Denise
I don't think I've ever heard it put quite like that Shireen, that grief is learning to live with that different relationship, that we still have the relationship. But grief is learning to live with it differently.  They’re physically gone but in other ways emotionally, they're still there, and spiritually, they're still there. They're around in some way because we can remember. You know, you might think, ‘Oh, what would mum have done in this situation?’ and you can tell yourself ‘Actually mum would have done this’ or ‘mum would have said that’, so they're still a part of our lives.

Shireen
Yeah, and I still make my Christmas cake recipe to my mum's recipe, and I have lavender in the garden because she loved lavender, and I have yellow roses in the garden because that's what my dad loved. And, you know, I maintain my relationship with them in all these different ways, and like you said, in times when we're feeling low, we might call on them and go, ‘What would you do? What would you say? I wish you were here.’…

I did have a lady – one of the times when I spoke about grief – feel like the idea that the grief never stops, that we are always grieving, felt really heavy and really hopeless and scary for her. And I think it's important to know that intensity, that same rawness doesn't persist, that it does get easier. And if it doesn't, actually, it's okay to ask for some support. It's actually okay to talk to somebody about it and get some help. Grief is normal. It's not pathological in any way. So asking for help doesn't mean you're doing it wrong, or in some way your grieving has gone wrong. We all need some help at various times in our life, and actually asking for some help, talking through some things with someone like a counsellor, is okay.

Denise
And I think what we need to remember when somebody suggests to us it's not okay, that they need to just go away because it's when you were saying before, that ‘Oh, you should be over it by now’ you have a few days off, and then you have to return to work, but that feels weird. And after a couple of months, it feels like everyone else in the world might be moving on, but I'm not and that can be really tough. So it's really good to have that reminder that actually, that's all okay, and you're allowed to feel that way. 

Shireen
I wanted to actually speak to what you just said about society kind of moving – on the people in our offices, the people, maybe even people in the extended family. It might look like they're moving on. 

Going back to that idea of grief is the price we pay for love. It's about how much that loss means to us. So for example, I have a teenage daughter, and her phone is attached to her hand. Now if she loses her phone, her life feels like it's ended. She's lost, she's lost something that has huge value. For me, if I lose my mobile phone, I don't care that much. It's an annoyance. I'll quite calmly go and buy another phone and get on with it. 

So we all place a different meaning on the loss we've experienced, even in the same family. And so therefore, we grieve in different ways. And we grieve at different paces and we grieve for different times. So the people in your office don't have that same meaning and that same relationship to the losses you do. So naturally, they will be grieving, they will move on, things will happen at a different pace to you. 

Denise
It's been recognised at times, I think too Shireen, that actually that period of time a few months after a death is often a really tough time because it's around then when life is starting to move on normally and yet actually part of us inside doesn't feel normal and so we don't quite know how we fit within that. 

Shireen
That's right. We can feel uncomfortable around people expressing strong emotion, and I think that might be a bit of a cultural thing as well. In some cultures, mourning loudly and crying and wailing is normal. For somebody else that might be difficult to be around. It can just be that someone is talking about their loss or talking about how they're feeling and someone else is not able to deal with that strong emotion, feels uncomfortable around it. And you're right – that can often be times when people might say things like ‘Shouldn't you be over it right now?’

Denise
And so, if somebody says that to you, you have the right to say, ‘No, I shouldn't be over it by now,’ and just keep yourself safe in those situation – know that actually, you're okay.

 Shireen
That's right. And know who might be safe people to talk to. I've had someone recently say this to me that she has a really good friend, but doesn't feel like she can talk to this really good friend about how she's feeling, but is able to talk to somebody else who she's felt has really been more of an acquaintance right now, but happens to actually be a safe person that she can talk with about this sort of stuff. So there might be some people who it's more safe to talk about the stuff with, and there might be some people that you keep the conversation at a different level.

Denise
Absolutely, I think that's really important Shireen, because sometimes the people that we think we might most be able to lean on, suddenly aren't quite there for us because they don't know how to handle the grief, and that could be their own history that's behind that. But someone else, as you said, that might only be a slight acquaintance but they understand grief for some reason, and they're able to hear you and be there for you in the way you need at that time. 

Shireen
Yes, exactly. 

Denise
And actually, it's good to have that friend, that we can perhaps have a light conversation with and not talk the heavy stuff and actually just pretend for a while, that life is normal. 

Shireen
Yes, you just actually reminded me of something. People can feel a bit of guilt when every conversation isn't about the loss, and they do start to become interested in other things, or wanting those other kinds of conversations or those other kinds of experiences. They might feel a bit guilty because it's it almost feels disrespectful, like you're abandoning the person who has died – and to know that again, that is part of the process, that is part of that process of adjusting to life with that loss.

Denise
That's really important Shireen, because we move through all of these different parts and we can go backwards and forwards amongst that, as we're struggling to live this new life, as you said, learning to live with that person in a different way in a different relationship.

Shireen
Absolutely, and there are good days, and there are days that are not so good. And having that ebb and flow is normal.

Denise
I have a good friend who lost somebody very special to her and she said to me, ‘It's not about good days and bad days. It's about good moments and bad moments’. And she said, ‘Sometimes I know when they're going to come, and other times they just hit me – and without any expectation. 

Shireen
That’s right, yeah. 

Denise
So it's good to remember that any of these things that we've talked about is normal, and that's okay. And allowing ourselves to feel, and to be, and to try and let go of that guilt.

If you feel you'd like to talk to someone then look to who you are options might be. It could be a counselling service, it could be through a GP. There are ways, but start first with somebody that you trust.

 Shireen
Someone you trust yeah, absolutely. 

Denise
Someone you feel safe opening up to. 

Shireen I'd like to go back to that idea that grief is learning to live with the person we've lost in a new relationship, because that sounds a little bit complex, but actually, it's something that we're all doing, all of the time, isn't it? Because we've always had losses, little ones, bigger ones. Most of us have lost somebody that we care about in our lives. And I guess we can reflect back on that and see how we've learned to live without that person, but they're still a part of us.

Shireen
Yes, you’re so right. I think there are a few things that can be useful to reflect on. One is, what difference did this person make to my life? What did they add to my life? How am I using their wisdom, their knowledge, their voice to speak to me in in everyday life? How do I feel their presence? And I don't necessarily mean that actually feeling spirit around you, but how do I know that they're there? 

You know, my mum, in the last years of her life, was in a different country to me, but I still knew she was rooting for me. I still knew that she was supportive, and I still knew that she was proud of me. Well, how did I know that? How did I know that she was proud of me? How did I know that she was always on my side? How did I know that this person loved me? How can I draw on what their learnings are about life, that might help me now and in the future?

Denise
That’s a really good reminder, because, they are still a part, and will always be with us. 

Shireen
It's about how we recreate that relationship, and what form it takes and, what feels right for us. And I guess the interesting thing is, along with those feelings of missing and longing, we also feel some of those lovely feelings that we felt when we were with these people. We also feel that same sense of safety, that same sense of peace or energy or whatever it is that they brought to our lives. Alongside that feeling of loss we also feel those really special feelings that come along with them.

Denise
And sometimes we need to just choose to focus on those. 

Shireen
Yeah. 

Denise
Hey Shireen, thanks for coming along and talking with us today. 

Shireen
My pleasure. 

Denise
And thanks listeners for joining us for another episode. 

This podcast was brought to you by Otago Community Hospice, with support from Hospice New Zealand. If you found this discussion helpful, check out our other episodes of Ending Life Well, a podcast series for carers. You can also find more resources for caring for a person who's dying at otagohospice.co.nz/education