Thursday, February 19, 2015

Complicated Grief "Disorder"? Really?

There is some hullabaloo going on about "prolonged grief disorder" aka 'complicated grief disorder.' Yep, another grief-related 'mental illness.'  According to a NEJM blog it is "condition is characterized by intense grief that lasts longer than would be expected according to social norms and that causes impairment in daily functioning."

Ha! Social norms? Around grief? Talk about pathology! Western culture's social norms around grief are as abnormal as you get. The average bereavement leave is three days, many bereaved parents are medicated within days or weeks after a traumatic loss (even in the presence of data to suggest these medications can be harmful and iatrogenic), and mourners are expected to get back to 'life-as-usual' often within weeks or mere months even after traumatic death.

The same blog continues:
"The hallmark of complicated grief is persistent, intense yearning, longing, and sadness; these symptoms are usually accompanied by insistent thoughts or images of the deceased and a sense of disbelief or an inability to accept the painful reality of the person’s death... the urge to hold onto the deceased person by constantly reminiscing or by viewing, touching, or smelling the deceased person’s belongings... often feel shocked, stunned, or emotionally numb, and they may become estranged from others because of the belief that happiness is inextricably tied to the person who died. They may have a diminished sense of self or discomfort with a changed social role and are often confused by their seemingly endless grief."

I've had many emails and calls about this. So, I will say, and those who know me can predict this:

I think certain groups are at risk of - again - being diagnosed and "treated" for absolutely normal feelings and experiences after an excruciatingly painful and traumatic loss. 

For example, I worked with a mother who lost her three children in a fire. Why would she not have persistent and intense yearning? Why would she not long for her children? Feel sadness? Experience an inability to accept their deaths? Why would she not feel shocked... emotionally numb? Why would she not experience a diminished sense of self? And let's not underestimate the power of being surrounded by cruel and insensitive others while in our grief.

Please consider that when others promote 'treatment' for a 'disorder' related to grief, they are asserting that these are aberrant - somehow abnormal - reactions. They are medicalizing what it means to be human, to love and to, rightfully, mourn. Um, sorry, no.

When the overwhelming majority of a population feel the same way, experience the same emotions, and contradict what others, on the outside looking in, assert are "normative", then I'm going to defer to the *real* experts to establish the Gaussian curve for that particular population.

I reject this idea that, somehow, a mother whose three children die in a fire or a mother whose two children are murdered or parents whose baby dies during birth or whose son died at three of cancer or whose daughter is raped and murdered are "disordered" for feeling the aforementioned symptoms. No way I will be convinced of that. Rather, a world wherein those horrific events can occur is deeply flawed and the tendency for our culture to pathologize the pain and suffering they expectedly would endure is a sickness. Of *course* they experience an 'impairment in daily functioning'. No shit Sherlock. This is a NORMAL reaction to ABNORMAL tragedies. Come on, let's use our hearts and our minds about this. What happened to basic common sense?  Of course grief is complicated. So is love. Heck, life is complicated. 

So here's the question: Do some people need support through traumatic grief? Oh yes, yes indeed. Many do. And here's the next question:  Need we medicalize and pathologize traumatic grief in order to provide aid? No, nope, no we don't. And we shouldn't. It is trivializing and dismissive and an offense to our humanity.

The best support and care we can offer is nonjudgmental loving, compassionate space to be with what is... others to remember and speak their names... unconditional respect for our emotional state... a place of safety... time to mourn a profoundly important and utterly irreplaceable relationship, time and space and kindness as we integrate the loss, and eventually, support without coercion, as we find meaning and purpose in life again if and when we are ever ready.

Monday, February 2, 2015

When the Media Utter the Words: Child Death

When the media utter the words 'child death'... all hell breaks loose. Especially during a party.

So this blog is not going to be popular. 

I can feel it. I'm in the minority, perhaps, but I'd like to offer a dialectical view on the big event during yesterday's football game.

My email and phone exploded during the Superbowl.  As many now know, the Nationwide ad about children dying sent many of the non-bereaved into a tearful frenzy.  Bereaved parents around the world who contacted me were split, though the majority supported the ad, especially those whose children died at home from accidents. Most, however, do not represent all.

And not everyone will agree, particularly about such an emotion-laden, censored topic in our culture.

So, many want to know how I feel.  I rarely respond to these types of things but - literally - my emails have amassed to the point where I am unable to respond to each one.  Therefore, the blog.

First, I know the non-bereaved were not expecting this commercial.  People may tolerate commercials about domestic violence. Feminine hygiene girl power.  Even alcohol related sentimentality. But something to awaken them from their delusion that, somehow, their child will never die? Nope. That is absolutely unacceptable.  A "buzz kill" to quote one blogger. "Debbie downer" to quote a news reporter.  "What were they thinking to air that ad?" to quote another.

And thus, many non-bereaved took to social media about the ad:

"Morbid," "somber," "horrific," "I cried!" "Why would they talk about children dying?"

Well, if you think it's morbid and horrific to watch an ad, imagine that this is your life. Oh I get it.  Everyone watching was in a party-with-Katy-Perry-on-a-pretend-lion-with rainbows and unicorns-leather and tights mode. But that isn't reality.

Reality? Well, children can- and do - die everyday.  And a certain percentage of parents watching the Superbowl's controversial ad yesterday- yes, some of their children will die. Some died today. And some will die tomorrow.  And for that, my heart breaks.

Tragically, that is the real outrage: the fact that every single day, parents lose their children, not just to accidents but to cancer, newborn death, illness, SIDS, homicide, suicide, non-preventable accidents, fires, medical malpractice, and the list goes on and on... How do I know? I've been a bereaved parent for two decades. And, I am a counselor to them every day, mostly seven days a week, for the past 18 years. Then, there is the research professor piece. I assure you, from someone who is immersed in this field of practice and study- as hard as it is to see an ad like this, to live as a bereaved parent is exponentially - unimaginably - unfathomably more painful.

Now, the bereaved who strongly disliked the ad... well, everyone is different. A few said their friends feared the ad was a reminder of all they lost... but really, there isn't a day when we are not reminded of all we've lost. Many parents I read on the net cited feeling 'triggered' as the main reason for their dislike of the ad.  Interestingly, however, most MISS Foundation parents, told me they appreciated the ad, even if they didn't "like" it, and even those whose children died in home accidents:  "If it saves just one life..."

I was, personally, not triggered and most parents I work with were not triggered because 'triggered' often comes with experiential avoidance.  And our group promotes integration, accommodation, making room for all the dark places that grief is in the aftermath of this tragedy.

Still, I recognize and honor that for some parents, the ad was simply- not ok. And that is to be expected to some extent. I'm saddened and sorry that some felt hurt by the ad. And Nationwide has its responsibility too...

Now, here is where I question them:

  • Did you consult with anyone on the inside about this ad?

  • Do you realize that, while accidents do cause children's deaths, many if not most accidents are not preventable?  Why not say that? Why not say, "While not ALL child deaths are preventable..." in your ad?  "Make Safe Happen" doesn't always work, you know? Even the most diligent and abiding parents lose their children to accidents. And do you realize how the parents feel after their child dies from an accident? Maybe there could've been some acknowledgement of that in your ad?

  • Did you consider the ways in which the ad might affect parents whose children died? And, if you did, what did that discussion sound like? Because I'd have liked to see Nationwide pay for a moment of silence to honor these children and their families, to bring awareness, not just to child death, but also, to the grief suffered in the aftermath of such unimaginable loss.

  • Did you consider asking an actual family to share their story with the public instead of using actors to dramatize that which needs no dramatizing? Oh - too painful? I'm thinking your ad couldn't have gone more south than it did so why not invite a real family to share the story of their real child who is worthy of recognition and acknowledgement.

In sum, this is clearly a polemic issue for so many.  

I am neutral on the ad.  I didn't like the presentation, yet, I think the concept was brave- I've never heard a company speak on this issue.  Yet, raising awareness is crucial, not just to prevent other deaths but also to open the door, even if objectionably and distastefully presented,  to dialogue.

So, I want to express cautious gratitude to Nationwide for getting an otherwise-apathetic general public off their asses to face this tragedy. 

We can discuss this. We should discuss this. We must discuss this.

Children can and do die.  It happened to me. Maybe it happened to you. It happens to more than 200 new families every month who join the MISS Foundation. 

And you- non bereaved person: It can happen to you. You are not exempt. Terrifying? Yes, we know.  Morbid? Somber? Horrific?  

Yes. Yes. Yes.  

So, go home and kiss your children and spend time with them and be sure they know how deeply you love them. Why? Because death is inevitable for us all, and because even children die.  Remember that every moment with them is a gift. 

We are all vulnerable creatures holding tightly to that which we love.


Deep bows and appreciation to those who have allowed me to share my heart.


The soul still sings in the darkness telling of the beauty she found there; and daring us not to think that because she passed through such tortures of anguish, doubt, dread, and horror, as has been said, she ran any the more danger of being lost in the night. Nay, in the darkness did she, rather, find herself.

--St. John, Dark Night of the Soul

Follow me on Facebook