Oakland Fire CISM Team:
Coping with Grief

Heartbreak hurts, Compassion heals: The Centre for Living with Dying What is Grief? What is Stress? What is Loss? All of us, at some point in our lifetime, have experienced loss or change. It is the one thing that unites us as human beings. Grief is the natural response to any loss or change in our lives ­ even positive change. Even getting married can be a grief process ­ why do we cry at weddings? Let us take a moment and acknowledge losses and changes we may have experienced. Grief is a spiral of feelings and reactions. It is not a line with a beginning and an end. It can be roller coaster of unexpected memory triggers. We refer to them as landmines, because they are sudden and unexpected. There are three types of landmines: 1.Sensory Triggers, 2.Memory Triggers and 3.Time Triggers. Trauma research shows us that stress and trauma is taken in through the five senses, so even when our mind is keeping a distance, we are still imprinting in our brain all of the details of the illness, the trauma, the pain. This occurs in both witnessed trauma and imagined trauma. Trauma and grief know no time. It doesnąt matter how long ago the grief happened, sometimes, when we hit a landmine, it may feel like it happened yesterday. The Backpack Effect ­ Present grief can tap into grief that has occurred in the past. So, we are not only dealing with present losses, but it can touch the past as well. The truth of grief is that it is eternal. All our grief meets in the moment of our present loss or trauma. What may help is to identify what has been brought up from the past ­ realizing it may have as much emotional impact as the present. The Heart Hotel ­ One of our clients said it very well ­ "My heart is like a hotel. Everyone I love has a room in my heart hotel. When they die or go away, no one can take their room in my heart hotel. I can fill up the empty room with the love and the memories that even death or separation can't take away. I am also like Mrs. Winchester. I can add new rooms to my heart hotel as I meet new people to love and care for. This is the work of grief ­ like having another full time job ­ to let go of the pain, trauma and grief and keep the love, memories and good times. It is like a sifting process. It takes time and patience, and understanding that you are normal person having a normal reaction to an abnormally stressful event. Let's review: Acute ­ Immediate reactions, usually laced with disbelief and numbness Delayed ­ After the shock has worn off, usually after the funeral if it has been a death, the reality begins to sink in. Cumulative - A backpack of past losses and trauma that can be activated by the present loss. Occupational ­ Especially for professionals who work on the front lines of grief - The secondary trauma of how you are handled after a grief or critical incident. Symptoms of Grief: What are the feelings, behaviors, thoughts, body reactions and belief systems brought about by loss. What happens? Guilt Suicidal Feelings/Thoughts Substance Abuse Strained relationships Inability to function at work or at home Depression Apathy ­ I just donąt care Anger, Hostility Crazy Memories / flashbacks Sleep disturbance Eating changes/disorders Loss of belief Loss of friends, support systems Yearning and Missing Loneliness Isolation Disbelief Relief Physical Pain ­ GI, Head, Shaky, Disoriented, etc. Sadness Numbness ­ shock Relief These responses and reactions are normal. What helps: One of our wonderful volunteers at the Centre said it very well ­ "I will never be the old normal I was before my daughter was killed. But I have learned to build a new normal by acknowledging and expressing my grief. In some ways, I am a better, more compassionate person, because I have survived and made meaning out of the loss." From our founder, "The pain never goes away, but the memories are what I can keep. And the pain changes ­ from the gut wrenching anguish to the bitter-sweet sorrow. The pain of grief is the price for having loved." Four steps The Centre has developed to survive the transition: Acknowledge what has happened to you and your reactions: List your fears - both real and imagined Be specific and write them down. Focus on what is most difficult to handle RIGHT NOW. What do you need to do to help the situation RIGHT NOW. Express your feelings and issues: Talk with a co-worker or supportive person. See a non-judgmental support person/counselor who is not a part of your job environment. Write your thoughts and feelings down. Act: Do specific, concrete actions to facilitate the changes you are experiencing. Complete and bring closure to any unfinished business or unclear interactions with co-workers, friends, family and clients/customers. Do something playful, fun, and relaxing that is totally disconnected from work to balance the work stress. Normalize the rest of your life as much as possible. Do not change too much at one time. If there are other life changes you have no control over, acknowledge them. Realize that you only have to deal with the most pressing issue RIGHT NOW. Celebrate (Building a new normal): Give yourself the opportunity to acknowledge your victories. Look back at what you have survived and accomplished. Do something fun and life affirming which rewards you for a job well done. Managing stress grief involves honoring the grief process - the natural response to any change or loss in our life - whether it is positive or negative. Anniversaries, Landmines and the Waves of Grief It is important to remember that grief, like the ocean tides, may ebb and flow. Pay attention to your changing moods and reactions and remember, all you have to do is ask yourself two questions: What is touching/hurting me the most, hitting me the hardest, the most difficult, Right Now? And what is it that I need to get me through it Right Now? Remember, it is our human right to grieve. As each of us honors our own grief and supports others, The Centre for Living with Dying will be able to go out of business. Homework assignment We have explored a very difficult topic in depth. Do something life affirming, fun and healing for you. The balance of grief is life. Get connected with what is sweet in your life today. Please know we are here for you at the Centre for as long as the need exists. The Centre for Living with Dying 554 Mansion Park Drive o Santa Clara, CA 95054 408.980.9801 Fax:408.980.9838 www.thecentre.org For over 27 years, the Centre has provided support, intervention and education on the life issues of serious illness, trauma, loss, death and grief to over 1 million people. Our goal is to acknowledge grief as a normal reaction, and to gently break the conspiracy of silence that often surrounds death, grief and loss issues. We work with children, adults and seniors. We offer services for as long as the need exists. We respond to schools, corporations and community agencies, as well as emergency responders and healthcare professionals, who work with loss and trauma on a daily basis. Family / Relationship / Child Response Families judge each other on behaviors, rather than the feelings and reactions behind the behaviors. Every person may have a different responses and behaviors in grief at different times. There is no right or wrong way to grief, but these differences can often alienate family members from each other, increasing the isolation of grief. A good way to work with families is to get to the feelings behind the behaviors. They often are the same, even though behaviors are different. By establishing the groundrules of oconfidentiality and ono cross talk or commenting on others' feelings or reactions, a safe place can be created to give everyone the opportunity to discuss what has been difficult and what it is they most need from each other. They may not be able to get all of what they need, yet this process opens the door to explore alternatives where more people can get more of what they need and also support each other. It is helpful to have a neutral person facilitate the family meeting. Children need three things in grief: Honesty ­ brief but clear explanations and answers to their questions. Use direct language ­ died, dead, very sick, seriously ill, etc. When adults donąt know, be honest about that and explore with the child what they think. What children do not learn about from adults, they manufacture in their own minds. Choice ­ about their level of participation in services, at the hospital, in the home, etc. Safety ­ to know they will be taken care of and that their feelings and wishes will be honored Needs/ Donąt Needs Let's make a list of what you need and what you donąt need. In grief and trauma, we are more alike than we are different in our responses. We don't need to be fixed, we do need to be validated. If you take a look at both lists, the don't need list is full of all the ways people try to make it better, explain it away or fix us. If we examine the needs list, there is nothing we have to say to make it better. We simply have to be there.