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Secret #51: New Thinking on Grief with Dr. Ray Owen
147 Plays19 days ago
Grief is an inevitable part of life, but do we truly understand its complex nature and the different ways it affects us? Dive into this enlightening episode as Dr. Ray Owen, a seasoned clinical and health psychologist, unravels the multifaceted world of grief. With over forty years in the National Health Service, Dr. Owen brings unparalleled insights into the universality of grief, its manifestations beyond just sadness, and how cultural nuances affect our grieving process.
Explore why grief can be so much more than just a singular emotion, as Dr. Owen discusses everything from anger and shame to the dark side of resilience and the concept of disenfranchised grief. Together with hosts Emma Waddington and Chris McCurry, this episode delves deep into the cognitive processes that accompany loss, whether it's the death of a loved one, a pet, or even an identity shift due to life changes.
Perfect for anyone experiencing loss or for those seeking to better understand this profound emotion, this conversation provides actionable insights and empathetic understanding. Decode the secrets of coping with Dr. Owen’s valuable perspective—your journey towards healing could begin right here.
Topics Discussed in this Episode:
- Universality of human grief
- Varied facets of grief expression
- Role of cultural influences on grief
- Challenges of disenfranchised grief
- Navigating loss and life transitions
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Transcript
Society's Pressure to Appear Infallible
00:00:02
Speaker
We are all very human and fallible, and yet we live in a society that rewards pretending we're not fallible, or the range of acceptable fallibility is narrow. We are constantly comparing our insides to other people's outsides, and feeling inadequate and guilty, even ashamed. Trying to blend in means parts of ourselves will disappear and we must then live in fear that we will be found out.
00:00:26
Speaker
Here, together, we will create a space where we can laugh, cry and carry our suffering and hurts lightly. In the service of being deeply human.
Introduction to 'Life's Dirty Little Secrets'
00:00:36
Speaker
This is Life's Dirty Little Secrets.
00:00:41
Speaker
Welcome to Life's Dirty Little Secrets.
Meet the Guest: Dr. Ray Owen
00:00:44
Speaker
I'm Emma Waddington. And I'm Chris McCurry. And today we are pleased and honored to have Dr. Ray Owen as our guest.
00:00:54
Speaker
Dr. Owen is a clinical and health psychologist who specializes in therapy for cancer and paliative care patients. In addition, he's an acceptance and commitment therapy trainer recognized by the Association for Contextual Behavioral Science.
00:01:11
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Dr. Owen has worked for nearly 40 years in the British National Health Service delivering therapy, supporting doctors and nurses, and leading a team of psychologists helping people affected by chronic physical health conditions.
00:01:24
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And he's published a number of scientific articles in respected journals and his self-help books, are highly recommended. one is called Living with the Enemy, Coping with Stress of Chronic Illness Using CBT Mindfulness and Acceptance, and also Facing the Storm Using CBT Mindfulness and Acceptance to Build Resilience When Your World is Falling Apart, which is now in its second edition. And there'll be links to those books and other resources in our show notes. So welcome, Dr.
Understanding Grief: Universal and Complex Emotions
00:01:57
Speaker
Owen. Today, we're going to talk about grief and the many ways that grief can present itself.
00:02:03
Speaker
So thank you so much for coming on with us. Thank you. Thank you for asking me. It's always a fascinating, if not necessarily the cheeriest topic to talk about. That's true. And most people, when they think of grief, they think of, you know, loss and sadness and sort of a classic picture of that. But I know in your work, you've really explored this topic and you've seen that there are many facets to this, many aspects, many presentations for grief.
00:02:31
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So I'm sure our listeners will have a lot to get out of this. Good, I hope so. you know One other thing that's always drawn me to grief is its universality.
00:02:44
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You know, we can go back to Freud saying that that grief is the price we pay for loving someone. I suppose on a more day-to-day basis, any of us who are lucky enough to have anything or anyone that we love in our lives and who are ourselves lucky enough to live, you know,
00:03:03
Speaker
through childhood into adulthood, will experience significant loss. And with that significant loss will come a variety of forms of pain and challenge.
00:03:14
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And I'd argue that grief is probably the commonest form a profound distress. that most humans will encounter. Most of us are fortunate enough, we're not going to find ourselves living with panic disorder, obsessive compulsive problems. Many of us will, but virtually everybody will grieve and grieve significantly at some point in their lives. And that's one of the things that that that drew me to this area.
00:03:40
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So in your work with people with chronic illnesses and death and dying, what are some of the ways that grief can manifest itself other than just, you know, sadness?
00:03:53
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It's quite a kind of commonplace to recognize that different, strong, powerful emotions can show up within grief. You know, one of the commonest, ah widely held models of grief sees us as walking through sort of phases, if you like, starting off with denial and anger and moving through depression and so on. And though nowadays we tend not to see that model as being that typical or that useful indeed.
00:04:27
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What that earlier way of thinking associated with a brilliant writer called Elizabeth Kubler-Ross did highlight was alongside, yes, that sadness that often seems the hallmark of grief, understandably, there will come sometimes come anger.
00:04:44
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There will come fear. And also, some of the less, if we want to put it this way, less clean, unpleasant emotions, the trickier ones, guilt, shame, regret, very common parts of
Cultural and Community Influences on Grief
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guilt.
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And sometimes for some people, kind of harder to make room for than the sadness, which... is more, I suppose, in many settings, sort of culturally expected. I guess I need to put a huge proviso over this, that you know with using the word cultural, that alongside stuff that may be kind of direct perspective products of how our minds and our brains work generally as a species many aspects of how we respond to loss how we construe loss how what we do next is shaped by the culture we grew up in so i can talk very confidently of kind of like you northwestern european cultures of various sorts but the things i say wouldn't want necessarily to be taken to be representative of every culture in the world because that wouldn't be the case
00:05:54
Speaker
Hello, listeners. I'm Emma. And I'm Chris. And we are so excited to share with you our latest workbook, Just in Case, Sits with Anxiety, which was published by Jessica Kingsley.
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The workbook takes us on a journey with Justin, who's about to have his very first babysitting job. He's excited, but quickly gets hit with a wave of what ifs. What if something goes wrong?
00:06:17
Speaker
Or what if he's not good enough? In the workbook, Justin overcomes the inevitable challenges of babysitting two toddlers whilst learning ideas and tools to help him understand his feelings and face those fears whilst learning to do what's most important to him, being a kind and resourceful kid.
00:06:37
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Based on acceptance and commitment therapy, it's packed with activities for kids plus helpful tips for parents. Order now on Amazon to find out how Justin learns to tackle his worries and move forward with courage.
00:06:54
Speaker
And why why is it that sadness appears to be so much more acceptable than guilt and shame and anger? You're saying it was, you know, there's that cultural message, but is there anything else?
00:07:09
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I suppose there is a kind of a... a dominance there they greet in that grief is really kind of a response to an absence to a disappearance of something important so that classic example is know that your life has been made worse by the absence of that element.
00:07:31
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And that's kind of how we tend to think of it was like one of the primary colours of ah ah sadness is something taken away, something lacking, something missing. So I guess that's one of the reasons why kind of sadness might be front and centre in grief.
00:07:46
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However, it's never that simple, is it? And we know that some of the folks who particularly struggle following, say, a bereavement, so where the loss is the death of someone, some the people who struggle most and for longest,
00:08:00
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are people where there was a very ambivalent relationship with the person who died, or an outright um kind of conflict relationship, or the person, you know let's take an extreme example, youre the person who died was your abuser.
00:08:15
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We know that sets up a complicated path on from there, and it's not as simple as just sadness.
Challenges in Grief Categorization and Therapy
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That is so interesting. And so is it, would you say it's just grief then?
00:08:28
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I mean, I think that's one of the central questions, actually. And the I'm not here to talk in great depth about the research because I'm not primarily a researcher. I know it's the questions that folks do struggle with on this.
00:08:41
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Whether when we say sort of the increase in traumatic memories, you know, the increase in anger at the fact that there can never now be a resolution, you can never either put things right or see the person wrong,
00:08:58
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suffer or punished for the awful things they did. You know, is that part of a grief process? Is that something else? From the position of a clinician, which is kind of what I am at heart, in a sense, we could get lost in that conversation.
00:09:11
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What's actually happening is this human being is experiencing these things. o And when we use a word like grief, some of it might be talking about specific processes of adjustment to loss.
00:09:22
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But most of the time, what we're talking about is a a context where the you this person has lost something and is now suffering as a consequence of that.
00:09:33
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And the different bits of it we may tease apart in different ways and try and support them. That's but part of the fundamental problem of diagnosing and categories is we we try to put things into these boxes and human beings refuse to be put into boxes and everybody's going to experience it differently. Again, whether it's depending on their culture, their personal history, their biology, whatever it may be. so yeah.
00:10:01
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Yeah, we can't categorize these things too neatly. No, and grief certainly has gone down that path. um You know, one of the one of the paradoxes of getting involved as a clinician is if something is so universal, is so much an arguably of a necessary part of the loving relationship and the response to the loss of, a say, a loving relationship, then what on earth are people like therapists doing getting involved?
00:10:31
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Great question. Yeah. you know And we know that the most appropriate and the most helpful things in the context of a loss, particularly loss by bereavement, are the things that kind every culture throughout history has found. You know, it's kind of compassion.
00:10:48
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It's practical support. At that time, you know, taking some food around, helping with things. Meaningful ritual. ah Again, what that what shape that fault that takes will depend. You could have rituals that are very like long cultural traditions and may or may not be tied in with religious belief systems.
00:11:11
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But you also have new and relatively spontaneous rituals. I was in Italy a few weeks ago and there sometimes on rural roads, you get little roadside shrines.
00:11:22
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And that's been a tradition that's been going for centuries and centuries. And of course, I don't know if this is true in other countries, certainly in the United Kingdom. ah This new ritual has developed just in the last couple of decades of flowers at the roadside if somebody, say, died in a road traffic accident.
00:11:41
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Well, that didn't exist before, but this is kind of a new ritual that has meaning. And so, yeah, the following of of meaningful rituals
Resilience and Grief: Societal Expectations
00:11:51
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and provision of companionship. You know, those are the core things. You don't need therapists, doctors, psychologists involved.
00:11:58
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for those bits. I think it's so, so important that you raise this because this is something that I ask myself too. And I guess some people don't get that support, don't get those rituals. And maybe that's where they turn to therapy or their grief is not considered what we call the disenfranchised grief, right? It's not recognized by society. So society or their community is not gathering around them and offering them that support, that compassion, right?
00:12:29
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that help or the support, the help, the compassion runs out because it's been too long and I'm putting air quotes and, you know, it's three to six months, you should be back to functioning.
00:12:42
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And that's how people turn to therapy because, you know, in our communities, and like you said, we can't speak to other communities, but in our community, grief isn't something that we do very well.
00:12:55
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We don't gather around very comfortably. And one of the things that strikes me about grief is that on the one hand, like you said, it's something we will all experience.
00:13:06
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And that was such a beautiful reminder of how common it is. And yet, you know, it can be labeled as ah condition. How common it is that we'll all experience grief and yet how uncomfortable we feel with grief.
00:13:23
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how most people that I work with who are experiencing grief or have had a ah terrible loss, an unbearable loss, feel really alone and feel often a burden to others ah because they don't want to overwhelm others with their grief.
00:13:41
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And so I do think that as a community, we're letting grief down. Like we're not very good at supporting grief. grief and accepting that we will grieve and that people can have these tremendous emotions. And that's sort of what you said about, you know, grief being very messy and complicated and lots of emotion. The sad, the ugly crying that we sometimes talk about, you know, with grief is acceptable, but so many others aren't. Although I think the ugly crying is also a problem for many people. Like they feel deeply ashamed and will isolate. So I think despite it being
00:14:16
Speaker
just a matter of time before we experience tremendous grief. It isn't something we do very well. And maybe other cultures do with that their rituals and their community, but I don't think in the West,
00:14:31
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we're too happy maybe not too happy maybe it is a bit of denial that we don't want to sort of to face the reality but I do think a lot of people find it hard and I do think it's cloaked with the mysticism like even as clinicians we're told you know can you see this client who's experiencing grief you go yes have you had training in it Do you know how to work with grief?
00:14:55
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So there's something about grief that's kind of, on the one hand, we all know what we need to do and how to support. On the other hand, it's incredibly difficult.
Dual Process Model of Grief
00:15:08
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I think that's astute point. And one of the things that's, I suppose, tied together a couple of threads in my career. has been both on the grief side after a loss or a significant change happened, and also in anticipation, whether of the death of another person that you love or of your own yeah old mortality.
00:15:29
Speaker
a change in your physical function that that alters your life fundamentally. You one of the things that ties them together is something very clear and very actual has happened. But we're not in the position of saying, oh, you see, this is all just about you've got this habitual way of looking at stuff that always gets you into trouble.
00:15:46
Speaker
And some people are really cursed with that and it ruins their lives. But with these kinds of situations, it's everybody's going to look at it and say, well, hang on, the person you love most them will just die.
00:15:58
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yeah Of course. So for that reason, I think sometimes simpler, more basic psychological interventions, which have sometimes arguably overemphasized so the internal causality, that it's a problem arising just from within,
00:16:17
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I think sometimes that can feel a bit intimidating when we're dealing with a big tangible thing. But there's a big societal sort of, not taboo, but a big societal recognition that, well, that's awful.
00:16:29
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So yeah, I think the, know, are you trained bit is not necessarily you need a fundamentally different set of skills, because I really think you don't. However, you do need to be ready to apply that in a context where the big bad thing ain't going away.
00:16:45
Speaker
That person will always have died and that person will always be absent. And so sort of looping a lot back a little bit to the slight tendency to diagnose, you know Which arguably, you know as you were saying, Chris, is sort of part of that way that humans make sense of the world by categorizing, trying to impose some sort of order on the chaos of reality.
00:17:07
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And of course, we import that in and it works arguably, works relatively well for lots of physical health problems. sometimes doesn't work so well around psychological distress and suffering.
00:17:17
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And in grief, we've certainly that distinction between, well, this is, and I'm going to take my turn to borrow the air quotes now, you know, normal grieving. And then,
00:17:29
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Huge amounts of ink have been expended in categorizing problematic or abnormal grief. And you can see, you know, with good heart why people have done that.
00:17:39
Speaker
To try and say, well, we shouldn't really be sending everybody off to see a therapist because they're sad that somebody's died. That's not right. And at the same time, if you have somebody five years in is still at this very high level
End-of-Life Care: Emotional Complexities
00:17:56
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of distress,
00:17:57
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you know, self-care gone out the window, unable to relate well to other people, constantly thinking about the person who's died, seeing no future for themselves in it, then I think it's worth saying that person could probably do with a bit of help or at least he deserves a try of something.
00:18:15
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So, you know, without getting lost in, at what point does it become prolonged grief or unresolvable grief? It's just, oh, look, here's somebody really struggling. Isn't it time that somebody kind of tried to sit down with them and see if there's any way we can help them a bit?
00:18:32
Speaker
And I think that's a more functional kind of distinction than this classic thing of categorizing and sorting. yeah I know one of the things that you've talked about is the whole idea of resilience.
00:18:48
Speaker
and how there's a dark side to that and how it's applied and that resilience can become just another kind of finger wagging, you know, you should be more resilient or ah way because we've on this podcast talked about burnout and how, you know, the idea of being more resilient, maybe just another way of, know,
00:19:13
Speaker
our overlords getting us to go back into a situation that's not healthy. Can you speak a little bit about that in terms of resilience and
Disenfranchised Grief: Beyond Death
00:19:23
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how that's been incorporated either for good or for ill in the grief process?
00:19:30
Speaker
Yeah, it's been fascinating to watch the development of the use of the word resilience and how bad a press it's got over the last decade or so.
00:19:43
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And absolutely, there is now that association with kind of, you know, blaming the victim in in a society which asks a lot and often too much of individuals in the pursuit of the well-being of others rather than themselves.
00:20:01
Speaker
And yes, the sort of the concept that anybody who fails to deliver and then deliver more on less and less resources It's a failure of resilience on their part if they can't rather a perfectly normal human reaction.
00:20:15
Speaker
So there is that bit. And that's why I think that interestingly, was a conversation went on with my publisher in the second edition of the book about the word resilience and whether we still wanted to use the word resilience, whether it now got such a bad press.
00:20:28
Speaker
I kind of fairly strongly defended it because the core concept is an important one. you know, when people were first talking about resilience in a vaguely psychological way, not just in a general language way, you know, people identified two components, which is the ability to recover from major setbacks and the ability to persist in the face of difficulty.
00:20:52
Speaker
Now, if it is your employer overlord who is giving you the setbacks and setting unattainable levels of difficulty of what's being asked of you, then absolutely that's kind of like an abuse of the concept.
00:21:07
Speaker
However, life will give you setbacks. This is an absolute given. And there is not just individual episodes of major setbacks that going to knock you on your backside.
00:21:19
Speaker
There's also going to be at times sort of continuing pressure that you're going to be working against. Not because somebody's abusing you and something's wrong, because that's what life gives us. You know, that's not much of a secret, is it? But it's that stuff will happen. You know, bad stuff happens.
00:21:36
Speaker
Sometimes you got to try to keep going when it's tough. And that's what resilience is referring to. So even if we're not going to ask people to be resilient in unacceptable situations, Things going just normally are going to recall that from us.
00:21:50
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And grief has an element of that as well. So these old sort of models that are sort of best known, that you go through these stages of grief, and at some point you'll get to acceptance.
Grieving Age-Related Losses and Life Transitions
00:22:02
Speaker
You know, very widely distributed in society, that sort of thinking. Sanctified almost, you know to the point that there's a whole episode of the Simpsons that refers to that model, and has Homer working his way through it.
00:22:16
Speaker
It must be real then. It must be real. I mean, how could it not be? you know And he manages it in about 30 seconds. So we're all clearly missing a trick.
00:22:25
Speaker
so well and One of the kind of consequences of that way of thinking, that grief is like based on phases or is in a linear time-based process, of course there's kind of truth in that because things do change somewhat over time with grief.
00:22:38
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That's most people's experience.
00:22:42
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But what one of the kind of much more useful models... of grief is something called the dual process model. Okay, which sounds very grand and sounds very scientific. I'll explain it. It's going to sound, well, yeah, of course.
00:22:56
Speaker
And what that says is, yeah, but you don't just sit around crying for the six months, for six months, and then maybe a couple of years later, you get around to, like, beginning to learn to do new things.
00:23:09
Speaker
Actually, those of us who have been bereaved or have suffered a loss of a non-bereavement type, recognize that normally you're having to do stuff right from the first moment. You're sorting out practicalities, you're sorting out the will, you're going down to the bank to see if you have some money released to pay the funeral director.
00:23:25
Speaker
So actually you're rebuilding life almost from the start alongside feeling the acute pain of loss. rather than being some linear sequence that you're worked your way towards.
00:23:38
Speaker
So in this model, it's like there's two, I mean, they call it orientations, but there's like two states that we kind of swing between, loss-oriented one and a restoration-oriented one, or we could say a rebuilding one.
00:23:52
Speaker
And it's not that we gradually move from one to the other, but even within a single day, we will swing backwards and forwards multiple times. And so at one moment, we are... wondering what on earth we're going to do about the future.
00:24:05
Speaker
In the next moment, we are actually sorting some of that future out. And in the next moment, we're back in the bedroom looking at photographs in floods of tears.
00:24:16
Speaker
And the pervasiveness of the idea that grief should be a more or less linear process is shown by the fact how many people I've met who describe these perfectly normal experiences.
00:24:29
Speaker
patterns of grieving and see them as being madness. I thought I was going mad. I swing up and down all day. Sometimes I'm doing this and sometimes I'm doing that. And when we can sort of walk them through, this is how we think a lot of people are.
00:24:45
Speaker
Just the relief that I'm not mad is so immense. So the two, yeah, those two aspects have been very much kind of woven together. Now, I could see how somebody would really be disturbed by that because, you know, if I'm really valuing this person and really
Therapeutic Support in Ongoing Grief
00:25:05
Speaker
grieving appropriately, you know, i should be completely bereft. But here I am, you know, like you say, I'm at the bank trying to sort out the finances.
00:25:15
Speaker
And that's where perhaps, you know, maybe. Worse yet, I'm laughing at some of the things somebody said, you know, at the funeral. And, oh, my goodness, I shouldn't be feeling any joy at this point in time. So maybe some resentment or some guilt starts showing up.
00:25:33
Speaker
And trying to make room for all of that is is a very tricky thing. It is tricky. And if we can help people have that concept that this stuff will show up, ah you know,
00:25:46
Speaker
It's true in lots of situations, and here's a particularly clear example of it. We don't really get to choose what shows up. All we get to do choose, have some degree of choice over what we do next.
00:25:57
Speaker
So enabling people to say that, yes, sometimes you will... So here's i mean here's a good example. Feeling kind of angry and resentful against the person who died. Not at the extreme we' were perhaps talking about before, where there'd been this long-term kind of toxic relationship, the person had been an abuser or something.
00:26:14
Speaker
But feeling angry may be that they died and left you. Even when you're not damn well, they have no choice whatsoever in the matter. The amount of extra knots that people tie themselves in around that feeling of guilt...
00:26:29
Speaker
and then their shame at feeling guilt, and their resentment at feeling shame, at feeling guilt. ah just you know It's what the Buddhists would call a second arrow. you know The first arrow is the suffering itself, and then the second arrow is the one we kind of shoot ourselves with, with all of those other complications.
00:26:50
Speaker
And that's where having a kind of a space and some support can really help people to be able to sort of see those things as well as sometimes the practical skills of how do you make room for guilt for shame.
00:27:03
Speaker
It's just so, so true that we get ourselves into knots about so many things. And the grief is yet another one that we get ourselves into knots about.
00:27:13
Speaker
Like this judgment and these sort of double, triple, quadruple arrows that we land in. Because there's no, because I sometimes, you know, in my practice and even with friends have ah you know been asked, but the normal way to grieve. What if I'm not crying?
00:27:30
Speaker
What if, you know, I had somebody ask me today because I asked my team, what are the questions? What are good questions for Ray Owen? And um one of them said, well, can you ask about, know, what if somebody hasn't grieved properly? They've just got on with life.
00:27:46
Speaker
Will it hit them later? And it just sounds like this. I mean, when I don't know who this you know what this person is experiencing and what getting on with life. actually it looks like. Maybe it is what you've said, you know, functioning because they have to function. But actually in the back room, like we say in, in you know, and on our podcast, you can't judge people's outsides because we don't know what's going on inside. So are they functioning? Who knows emotionally what's happening for them? But this idea that there is, you should be going through grief a certain way.
00:28:21
Speaker
You should be crying a lot. You should be feeling a lot of sadness, like you said. And yet grief can look very differently for for many reasons. Like so interesting to hear that, you know, if you've had a complicated relationship, because I see that, you know, and I have people dreading it. I have people dreading it.
00:28:40
Speaker
If my parent dies and I'm, you know, not speaking to them, how am I going to cope with their death? I should be getting ready for this now because, you know, like They can kind of see that it's going to be complicated already. So it's so it can be incredibly complicated, our experience of grief. And this idea that somehow there's a right and wrong way just gets us into more knots.
00:29:02
Speaker
Oh, absolutely. You know, i spent but many years, part of my work was in hospices. And one of the things I got very used to was the ward, doctors and nurses tended to be very accurate.
00:29:17
Speaker
in picking up who needed extra support, particularly family members. So my work was with the person who' was ill and dying. Sometimes it will be with family members as they were kind of living through them the last week's days, hours of the of the person's life.
00:29:33
Speaker
But very often the kind of thing that staff were picking up is, I think they're going to really struggle afterwards. you know And for the seasoned hospice staff to be saying that is not just a general statement of truth.
00:29:46
Speaker
It's, no, we've spotted something. Interestingly, couldn't always quite articulate why. eat But it's just like, they could smell it. This person's going to really struggle. And sometimes that's about the things that we know are kind of, again, it becomes medical to talk this way, but kind like risk factors.
00:30:03
Speaker
for more problems in grief. you know So some of it is about the previous struggles that person has had, if they've struggled with mental health difficulties all their life or they struggle significantly with previous losses.
00:30:14
Speaker
Sometimes it's about the person who has died. So yeah, we've talked a bit about ambivalent relationships. I mean, that sort of lifelong ideal relationship and the loss of the kind of the soulmate, of course that hits people phenomenally hard.
00:30:33
Speaker
kind of a sort of suggestion that hits harder earlier. And if you've been lucky enough to be in that kind of relationship, maybe do you know relatively better later because there's less murk and awfulness about. Something about, sometimes also about the circumstances of the death.
00:30:52
Speaker
So, okay, this doesn't really apply to hospices so much. it does occasionally. But you have very sudden, unexpected deaths. At the other end of it, very protracted, long deteriorations and high burden of care.
00:31:03
Speaker
And, of course, we know things like death by suicide. ah death by homicide, violent deaths, deaths where there isn't a body, so the death is sometimes just assumed, or death is certain, but there wasn't a body.
00:31:15
Speaker
We know some of these things are kind of risk factors as well. And, ah you know, is what we're working on then purely grief? Well, it comes back to the idea we were talking about before. kind of almost doesn't matter.
00:31:26
Speaker
You're dealing with a human and a human with suffering. If you've got some idea of the processes of, oh, here's some of the stuff that loss tends to do to people – Here's stuff that being plagued by traumatic memories tends to do to people.
00:31:39
Speaker
Then we work with the person rather than work with a categorization of a diagnosis. I find it really interesting to think. It's just so much more liberating when we're thinking about just emotions as opposed to right or wrong emotions. What emotions come in what sequence? And, you know, are we there yet?
00:32:02
Speaker
Have we got to the right stage? And when am I going to get to acceptance? And, you know, you can just hear the struggle. And I can see why certain deaths would be more challenging because there's more emotion that comes with it.
00:32:17
Speaker
Like you have a bigger pot, to bigger a container. You need a bigger container to carry all of that versus, you know, some of the other grief that you've described that perhaps the container neater and therefore easier to carry.
00:32:30
Speaker
don't know. I think by the time you've kind of looked at the sort of personal history of the grieving person, the nature of the relationship between the grieving person and the person who died, the nature of the death and time but left off the death, the context, because we haven't even talked about the fact that, you know, all of this so far is kind of fairly...
00:32:54
Speaker
within or between people psychological. You know, if people are simultaneously by the death being rendered homeless or stateless, maybe, you know, suddenly all these other sort of societal factors...
00:33:10
Speaker
really come into play quite apart from what you mentioned before i'm kind of astutely that um you know some death some grief is disenfranchised you know is is less approved and okay and you know i we've seen the textbooks and and all the examples you know i suppose classic ones would be that i've certainly been involved with were where the grieving person had a decades-long affair with the person who died. And, of course, when the person died, the sort of the formal legal family were very much the centre of attention, but this person you know couldn't even show up at the funeral.
00:33:50
Speaker
So you've got that. You've got where people will disagree on the grounds of ethnicity or sexuality with the nature of the relationship.
00:34:02
Speaker
So, you know, that's kind of not okay. I tell you, the biggest single one is whether it was human or not. Biggest single source of disenfranchised grief is death of a pet. Sometimes a pet is the single best relationship a person has ever had.
00:34:17
Speaker
The only non-abusive one, the only unconditionally loving one, the only one that's not like, you know, based on what can I get out of with most animals.
00:34:28
Speaker
Devastating for the person. And psychologically, way more significant than death of any human they happened to have shared the world with. And yet, just a pet. Oh, for goodness sake, it was just a pet. Get another one.
00:34:41
Speaker
So, you know, in terms of working with disenfranchised Greeks, that's the category I've come into I don't think anybody's ever come to me because of the death of a pet, mainly because they were ashamed But you start peeling the layers away of if why is this person reacting? And then you discover that, well, actually, they presented for this problem, they presented that problem. But actually, what's driving in the middle of it was, you know they lost their soulmate who happened to be a dog, a cat, or whatever. And that's what needed the work.
00:35:10
Speaker
And so what that sort of leads me to think about is different types of grief, right? that's We described ah disenfranchised in terms of the loss of a partner or a pet, a loss of a being. But some people experience tremendous grief, loss of identity, right?
00:35:32
Speaker
And they lose a job or they lose a status. a status and they you know They're no longer married. or So there's different types of grief in that way too. I wonder if we can touch on that because that brings people to... There's just getting old, which...
00:35:48
Speaker
Awesome. near and dear to my heart at this time ah there's a lot of loss just and number of years ago i was working with an older gentleman he was in his early seventy s as i am now but i was quite a bit younger and they had some anxiety issues and we did some nice work together but one day he was talking about getting old And I think Emma's heard me mention this before, but he said, when you get old, you experience a lot of loss.
00:36:16
Speaker
You know, your kids move away your knees don't work so well anymore. you know, you lose your job or you retire and then that's part of your identity. Maybe, you know friends and a spouse die.
00:36:29
Speaker
He said, it's a lot of loss, but he said, it's like playing at a game of chess. said, when you play chess, you're going to lose pieces. It's part of the game. And sometimes you may lose an important piece, like a rook or maybe even your queen, but you don't quit the game.
00:36:45
Speaker
You adjust your strategy based on the pieces you have left, and you play the best game you can. And I have thought about that for the last like, you know, 12 or 15 years as I lose my chess pieces over time.
00:37:02
Speaker
you know, my son moved ah out and body doesn't work so well anymore. And so, you know, just trying to play the best game you can with the pieces you have left. And, you know, grieve the loss of some of these things, of course.
00:37:16
Speaker
But the orientation, the focus is on favorite definition of resilience is struggling well. nice And I've mentioned that to parents on many occasions where, you know, it's a struggle. We're struggling well.
00:37:29
Speaker
And I guess what that makes me think chris is, is that sometimes I work with people is to work out what well means. but that Because can be very easy to be attached to the kind of the obvious surface form of things, you know, the chess pieces themselves.
00:37:45
Speaker
And yes, they go. And yes, there's pain of them going with the concept of what game am I actually playing here? gives us then the chance for saying, I'm still in the game and I'll play my strategies. And as you say, struggling well, well, you know, that kind of begs a question about what we mean by, what we mean by well.
00:38:04
Speaker
And it may not be pretty. this No, as my, my mother, i grew up in the Northwest of England was, it was very fond to say and know ah in her later years is that there's no good about getting old.
00:38:16
Speaker
and it's ah You know, yeah. I mean, that there are benefits, aren't there? It's meant to be the accumulated wisdom and all these things. yeah Discounted cinema tickets, yeah.
00:38:27
Speaker
Well, there we go. I've not quite hit that yet this soon, but for sure, yeah, yeah. There are many losses, and some of them are kind of those, if we're lucky enough, are those gradual losses.
00:38:38
Speaker
losses which still hurt. And, you know, we have some opportunity for sort of adjustment to, um for kind of like getting, kind of getting used to.
00:38:50
Speaker
I think where gets tricky are when we have like multiple losses very close together. And again, in yeah it's easy to think of bereavement type losses for that.
00:39:01
Speaker
You know, when when we do get older, then obviously more of our friends are dying. But even with younger people, you know, one of my first jobs out of qualifying was at a regional HIV and AIDS unit in the early 1990s, where, you know, we were supporting quite a cool cohesive community in Manchester who were losing an awful lot of people.
00:39:23
Speaker
and everybody had lost multiple people and previous partners and things. So, you know, that sort of, you can get very specific situations where you get these kind of concentrated losses. But as we say, like with age, we get that.
00:39:34
Speaker
So there are multiple, there multiples of losses. But also I think sometimes there's a kind of added shock from things being not in the natural order of things or sooner than people would anticipate.
00:39:46
Speaker
So one group I've worked a little bit with I've been sports people, athletes, whose careers have come to an end, unexpectedly, which is, of course, a kind of a real possibility.
00:39:59
Speaker
And you kind of meet these young people who are in their you know late teens, early 20s. And since they were young enough to know they loved sport and to be being picked out as something a bit special, that's been their entire lives.
00:40:13
Speaker
It's been all their time, all their energy, but it's also been their identity, the place they get validation or where living by their values. All of those things are constantly around the sport.
00:40:25
Speaker
And then it can get taken away from you in the blink of an eye. You know, one tackle that kind of wrecks your ligaments. And then suddenly at the age of like you know early 20s, but even if they have a successful career, make it all the way through to the grand old age of 30,
00:40:42
Speaker
when it's time to retire, you know, suddenly we're in that situation of, say, of having two sets of problems. We've got the grief for what you're losing and we've got the rebuilding.
00:40:53
Speaker
So it's actually very much back to that ah grief. yeah It's the rebuilding. What am I going to do next? And, you know, how can I live by those values that used to get supported in my sports life in a life beyond being an active athlete?
00:41:10
Speaker
But... If we spend all our time on helping the person build the way ahead, what we would call restoration or rebuilding orientation in this model, and we don't spend enough time saying this really sucks, doesn't it?
00:41:26
Speaker
It must really hurt. that you're not that anymore. Let's just make room for that and notice what happens so if we get too tangled up in it, you know, but make room for it as well as moving forward.
00:41:39
Speaker
And what I would say that just zooming outwards from, even from this wider level of grief is in therapy generally. i think those of us involved in more like behavioral therapies, more than purely reflective insight-based therapies.
00:41:54
Speaker
We're very often helping people build their way ahead. build a life that more suits their values than what they've been enjoying recently. And I think it's great to have therapy models that allow you to do that. I really do.
00:42:08
Speaker
And I think one of the big risks, and I see it a lot in but younger therapists who just getting into this kind of stuff, is you get so hooked on building the way forward.
00:42:19
Speaker
that if you get to make room for thee, that really sucks, doesn't it? That really hurts. Can we just spend some time with how unfair it was that happened to you? I suppose that would be kind of my other point that, yes, we can think about grief for bereavement.
00:42:35
Speaker
That's going to be the biggest part of you your work in some ways. But then there's grief that's around other major life losses, loss of role, loss of job, loss of career, loss of identity, loss of health and youth.
00:42:49
Speaker
But then there's also that bit of grief that's just a part of everything. And if we don't make a room for that, then we're less able to do the other stuff that we want to do as, say, therapists.
00:43:01
Speaker
And that may be a good place to end. Any final thoughts, though? Okay, here's my final thought. but There's a dilemma in grief therapy, right? Grief for somebody you truly loved is a lifelong process.
00:43:14
Speaker
It will change. It shouldn't be so high intensity, but it's lifelong. So when would grief therapy end? Because the grief's still going to be there. So it is kind of what came to me all the time.
00:43:27
Speaker
That when thinking about grief and grief therapy... The person you're helping is like a ship and they're going to sailing off across the Atlantic onto their own steam in the direction they're choosing.
00:43:40
Speaker
As a therapist with a little tugboat, we know about this harbour. We know where some of the currents are. We know where some the rocks are. We can sometimes work with them and their engines to get them off the odd sandbar and help them work out which way they should be pointing as they leave the harbour and set off on their lifelong journey.
00:43:58
Speaker
And at that point, we have to cast off because if this little tugboat stays tied to that big ocean liner, I'm going to be pulling you off course and I'm going to be holding you back.
00:44:10
Speaker
So although it might feel a bit scary at that point, we need to cast off and I need to wave wave you on your way and wish you well with the future ahead. I love that.
00:44:20
Speaker
That's really lovely. Thank you so much. I have learned so much today, honestly. It's just been really nourishing and validating of so much of ah of what I've witnessed and seen. and I've learned a lot.
00:44:34
Speaker
Thank you. Thank you for asking me. Thanks so much for tuning into the Life's Dirty Little Secrets podcast. If you have any feedback for us or secrets for future episodes, you can email us at lifesdirtylittlesecretspodcast at gmail.com. Be sure to follow us on Instagram at Life's Dirty Little Secrets or on Facebook at Life's Dirty Little Secrets Podcast.
00:44:58
Speaker
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00:45:09
Speaker
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