The Grief Wishlist

When my mother was dying, I was pregnant with my first baby. As you can imagine, there were a lot of complicated feelings swirling around: joy and relief (it was a process for me to get pregnant; this was a very wanted kid) mixed with grief and anxiety and also hope that my mom would be alive when the baby came. As close as we were, it was almost impossible for us to talk about the idea of her dying before I became a mother. Mostly we didn’t talk about it at all. Then one day she suggested that I write down a list of questions for her about babies and she would write down the answers. Just in case.

I never did it.

Not because I didn’t want her answers; I wish I could go back in time and write down a hundred questions for her. But at the time I didn’t know what to ask and honestly, I didn’t want to admit to her or to myself that she wouldn’t be with me when I had the baby.

I wish I had written down something.

I’m sharing this story because it is typical of grief. “I wish” can be followed by any number of should have’s or could have’s, if we had only known that the person in question was going to die. I hear it from my clients: “I wish we had spent more time together” or “I wish I was more patient.” The grief wishlist can be unending if we let it be. There is always some regret when we lose someone we love.

The question is, what to do with those feelings? When I hear my clients say they wish they hadn’t spoken sharply to their loved one, or they wish they had been more present, I don’t wave it away and say it doesn’t matter. Instead, we sit together with the sadness and the regret and the guilt. We acknowledge all the things that can’t be fixed or changed once someone is dead. We talk about what the wish really means, which is usually, “I miss this person. I want them back. I wish they hadn’t died.”

Feeling our grief is the only way through it. When you find yourself saying, “I wish” or “I should have,” don’t run from that feeling. Tell someone you trust (ahem, like a therapist!). Write it down. Acknowledge that your grief is complicated and nuanced. Consider your grief wishlist as a tender, loving tribute to the person you miss. Personally, when my grief wishlist feels heavy, I talk out loud to my mom. It’s a private conversation so I won’t share it with you but I will tell you that doing that helps me. There’s something that will help you too; you just have to find it.

Can I swear in therapy?

If you’ve ever wondered if you can swear/curse/cuss in your therapy session, I have great news for you: the answer is (mostly) yes!

I’m not suggesting you walk into your therapy session ready to use every foul or vulgar word you’ve ever heard. But there is evidence—actual scientific research!—that cursing can be helpful when we are in pain. Sometimes other adjectives fail us and the only way to explain how we’re feeling—the depths of pain we find ourselves in—is to switch to the four letter words.

Additionally, therapy is not the place to censor yourself. Therapy is meant to be a safe space to say whatever you are thinking, however it gets best expressed. For some people (myself included), cursing is a key component of that expression. Sometimes the only words that can accurately describe our pain are the “bad” ones. As a therapist, it’s a relief to me when my clients drop a swear word here and there because it shows me that they’re comfortable with me. The relationship between my client and me is the most important part of our work together; being able to express yourself naturally, without apology, is key to the foundation of that relationship.

Not everyone needs to express themselves this way, of course. Personally, I grew up with an Irish Catholic mother who could make a sailor blush if she was really on a streak; cursing was normal in my house. As with all therapy-related topics, your mileage may vary. But if you’re in a room with me and you want to explore your feelings by swearing, go nuts. I’ve heard (and said) all the words before. I may even join you.

Doorknob communications

The first time I heard the phrase “doorknob communication” was from a student I supervised. She was a little shaken when she brought it up, having just had a client confess something major to her at the end of their last session together (get it? The therapist’s hand is on the doorknob when suddenly the client says the most important thing). That original blog post still exists but it was time for an update. Now that I’m in private practice, I have a much deeper understanding of what the phrase means, why it happens, and what it feels like for both therapist and client.

Let’s begin at the beginning: my therapy sessions are 45 minutes long. Both the client and I know that from day one. That being said, the first few sessions we have together can run a little longer. Some people come to therapy ready to absolutely spill their guts; that 45 minutes flies by when someone starts talking and can’t stop until they get the entire story out. A new client is often on the brink of something—the depth of their grief; the physical and mental toll of a lengthy illness; the weight of caregiving—making those first few sessions a kind of stream of consciousness. And it’s quite often that it isn’t until around minute 43 that a client gets to the really juicy stuff.

This is partly my fault: once someone starts to get close to an important point or a long-held secret, I really don’t want to cut them off. But when I don’t, I’m left scrambling at minute 46, telling them that while I appreciate we’ve just opened a door, we have to slam it shut again until next week; our time is up.

Extend your session time, I bet you’re thinking. But here’s the thing about the doorknob communication: it happens right before the clinician wraps up the session, no matter how long the session is. When clients do this, they're giving themselves a way out. If they decide they don’t want to deal with whatever it is, they don’t have to; they haven’t left enough time to talk about it. There’s nothing forcing them to come back next week. For some people, they had to tell the thing and then they have to bail out, like they’re on a sinking ship.

But most people do return (one of my clients warmly reminds me every session to write down where we left off so we can continue in that same spot next time, like one long conversation split up into weekly installments). And as they keep returning and the relationship continues to grow, the doorknob communications lessen. It becomes less scary to say the Big Thing(s) to someone you trust.

So if you are just starting out in therapy and you find yourself only getting to the Big Thing(s) at the end of the session, hang in there. As you get to know your therapist, the harder stuff will come up more easily, leaving you more time to dive in. And, best of all, you get to tackle it together, in however much time it takes.

"I don't know what to say in therapy."

Let me begin with a small personal confession: this is the longest I’ve ever attended therapy as a client.

Maybe that doesn’t seem like such a big deal. But as someone who has made a living explaining why everyone should attend therapy actually, it feels mildly embarrassing, like forgetting the name of an acquaintance at a cocktail party. “Therapy is wonderful!” I’ve told people over and over for more than a decade while also not actually going myself for longer than 3-5 sessions. I’m a hypocrite, is what I’m saying.

I’m confessing my hypocrisy because I suspect a lot of people are like me: an acute crisis or some other event occurs that leads them to a therapist. They attend anywhere from one to maybe even ten sessions. The crisis passes; things get a little better. And they think, “well, I guess there’s nothing else to talk about.” So they stop seeing their therapist.

I hear this from clients sometimes: “I don’t know what else to say.” Or, “I don’t know what to talk about today.” Or, my least favorite, “what do you want me to talk about?” At that last one, I usually smile and reply, “that’s up to you.” I imagine my clients are not fond of this response but it’s the truth! I can’t see inside your brain. You have to tell me what’s in there that you want to explore.

All that being said, I get it: sometimes I struggle with what to say to my own therapist. She asks me how I am and I say, “I’m good!” and then immediately wonder if that means I should stop going to therapy. The crisis that brought me back to the proverbial couch almost a year ago has passed; I am good. But that doesn’t mean there’s no more work to be done.

The other week, when I really did feel ok, I felt myself about to say those dreaded words “I don’t know what to talk about today.” Instead, I told my therapist that sometimes I’m afraid that I won’t have anything to say and she’ll tell me I don’t have to come back. She laughed (kindly but still, she did laugh because it was ridiculous). She assured me that she wouldn’t say such a thing. And that was all I needed to find a new place to begin. The storm that brought me in has passed but now is the perfect time to do some deeper mining: when I feel well enough to really explore the deeper stuff.

So if you find yourself in therapy at a loss for words, that’s ok. In fact, it’s good! It may be the beginning of a new phase of your work in that space. Hang in through the lull and you may find you can feel even better.

The pain and comfort of shared grief

This is not what I wanted to write about today. In fact, I had started a totally different post yesterday. But this morning, whatever I had written before seemed pointless in the face of yet another senseless tragedy.

When a tragedy occurs—a mass shooting, for instance, or a racist murder—we experience grief, even if we haven’t been directly impacted. I don’t personally know anyone who was killed yesterday in Texas, or in any of the other violent tragedies that have taken place over the last several years, but last night I found myself crying in my husband’s arms, thinking about the devastation of those families and communities.

I’m not a big fan of the five stages of grief (the most commonly cited and probably most poorly understood theory of grief but that’s a discussion for another day). Despite my rejection of the five stage model, those first three stages describe my feelings at the moment: stage one, denial (this cannot have happened again); stage two, anger (why does this keep happening, what is everyone doing, someone should DO SOMETHING); and stage three, fear (we are not safe. My children are not safe).

I am rattling around between these three stages, both drawn to the news and social media and also wanting to hide from it. I want to talk about it at length with others but also can’t bring myself to discuss it out loud. I am alternately disbelieving, furious, and terrified. I want to do something useful but also feel paralyzed and useless. I am, in short, experiencing grief.

I know I’m not alone. So many of us who are parents talk about holding our babies close after this kind of event and that’s certainly something I did last night: I watched my children sleeping peacefully and thanked God they were safe. In my sadness and fear, I imagined parents all over the country doing the same thing. And I imagined all of us reaching out to hold each other up, clasping our hands together and sitting with the enormity of this tragedy and all the others that preceded it.

When something does not directly impact us, it can be easy to turn away from it (denial again, right? “That will never happen to me, ignore ignore ignore”). And there can be some turning away: we cannot sit only with pain all day, every day. But there can also be some turning toward each other. We can grieve together. We can hold space for each other in moments like this, acknowledging that witnessing suffering and tragedy is nearly as bad as experiencing it for ourselves. We can call what we are experiencing grief, even if it is not our personal loss to bear. We can be still in this moment and feel the wave of anguish, of anger, of fear. It won’t swallow us if we hold on to each other. It brings me a measure of peace to believe this; I hope it does for you as well.

How to Mark the Anniversary of a Death

I have never found the right word or phrase to describe the date of someone’s death. Anniversary sounds like something to celebrate; death day sounds flippant for some reason. Still, I can’t think of another way to say it so we’re going to stick with anniversary, which is technically what it is: an annual marker of an important date. And anyway, whatever you call it, the date of a loss is important and needs to be acknowledged.

A lot of people hang on to the idea that after that first anniversary passes, they will somehow be on the other side of grief. And although it’s true that time heals, there is no “other side” to grief. Which is not to say it never gets better; of course it does. But it doesn’t end. You don’t get to the other side so much as enter a new phase of grief. During holidays or birthdays or death anniversaries, our grief can grow again. As I've written before you haven’t had a setback when you feel your grief. Rather, you are continuing to experience normal, typical, regular grief. It ebbs and flows, like the tides.

Paths, tides, other sides: forgive my tortured metaphors. Let’s get more concrete: how should you mark the anniversary of a death?

The short answer is: however you like.

The longer answer is: it depends.

It depends on what will make you feel… not better, but comforted. What will make you feel that the day can pass without you white-knuckling through it? For some, the routine of every other day is paramount. I’m not recommending you ignore the day, but if it brings comfort and solace to get up and do your normal stuff, then that’s what you should do. For others, the day needs to be honored and ritualized and marked somehow. In my family, one of us texts the group chat with the number of years that have passed. It’s a small thing, but it helps to remember that we have suffered our losses together; that we are not alone in our grief. It’s a ritual, albeit a small one.

That’s the thing about rituals: they don’t have to be epic. You can choose to mark the day in a small, quiet, safe way. In fact, that may be the only way you can mark it. You can also choose something big and loud and intense. Your mileage may vary, as they say on the internet.

What’s important is that you figure out what works for you. There are no rules to grief and there are no rules about how to mark a death day. But I encourage you to mark it in some way: to write a note, share a photo, text or call someone you love who remembers. Tell a favorite story, take a walk in the woods, speak out loud to your person. Perform an act of service, sing a song, cry in public or in private. Find the thing that makes the day go by. Because it will go by. More days will come, some better and some worse. And on the worse days, I encourage you to lean in; let yourself feel. The only way out is through.

Talking to kids about death

I grew up in a house of death.

Which is not to say it was a sad or morbid place. On the contrary, my childhood was full of joy and happiness. I only mean that talking about death and grief was normal in my house. This was partly because my dad is a doctor, from a family of doctors. And it was partly because my mom had lost her father very young and she kept him alive for us with stories and memories. Later, our family suffered more tragic loss—a blog post for another time—and so talking about death and grief and loss doesn’t really stress me out. On the contrary, it feels like a natural part of conversation.

It turns out that this isn’t typical for everyone. I can tell because of the way people’s faces contort when I casually start talking about death and dying. It kind of freaks them out. And if adults are so freaked out or uncomfortable talking about death, it stands to reason kids would be as well.

But the thing is, kids are remarkably unphased by death. There are a few reasons for that. First, most of early childhood is a time of pure self-centeredness; kids can only understand the world and its events by how they are directly affected. (I don’t mean this derisively; it’s an appropriate developmental step). Second, and I would argue most importantly, kids take their cues from the other people around them. They don’t always listen to our words (as any parent can attest) but they do often mimic what they see us do. How we model big emotions—and grief is a big one—means more than the words we use to describe it.

We do also need words, of course. There’s a tendency to talk around the mystery of death, to use flowery metaphors instead of using the real words: dying, death, dead. Euphemisms may feel safer but they can be confusing and misleading. Shrouding death in secrecy like this isn’t fair to kids. We don’t have to tell them everything but we have to tell them something. We have to use the words: this person that we love, their body died. And listen, there will be follow up questions; namely “why?” (The whys are endless). And also, how? And—this one can be really tough—what happens when we die?

I know that all sounds intense. There’s a fear that of scaring kids or making them sad. But death is generally sad! Part of our job is to show kids how to handle big feelings. Basically, kids need to see that it is ok to discuss death and it is ok to grieve. I give you permission to cry in front of your kids; to say “I miss our person;” to explain that bodies die and to offer them a space to ask questions about that.

Talking to kids about big stuff—and death is one of the biggest—can be daunting. But I assure you, you won’t scar them for life by being honest and clear. You don’t have to make your home a house of death (not everyone is as cool as my family or origin). Start with the basics, don’t over explain, and most of all, let there be space to have big, tough feelings. For yourself, too.

The 6 month grief slump

“Shouldn’t I be further along now?”

This is a common question from the bereaved: however much time has passed, they wonder if it’s been long enough. The implied concern is, am I moving in the right direction? Will I get out of this? There is a fear of being forever stuck in the beginning, acute phase of grief. Additionally, there is a general idea that grief is a path you walk from the beginning (your loss) to the end (feeling “better”). But grief isn’t a straight line; it’s ocean waves. It’s peaks and valleys. It’s never gone; it only changes, from sometimes sharp to sometimes dull. And sometimes the wave or the valley or the sharpness can be unpredictable.

For a lot of grievers, the six month slump is one of the unpredictable times. The first round of holidays after a death or the first birthday without someone are expected to be tough. But around 6 months, a lot of people are shocked by a sudden wave of grief. It feels like a setback. For awhile there, they were feeling like things were getting back to normal: the funeral is over, they’re back to a routine, they are beginning to see what their new life is like. When their grief confronts them again, it is destabilizing. They feel they’ve gotten off track somehow.

But grief is not on a track, or a timeline, or a calendar. It is an experience that changes over time. We learn how to grow around and with our grief instead of trying to get away from it. The six month slump isn’t going backwards; it’s part of the process. Remember, you’ve been here before and you know the only way out is through.

Using Emotional Intelligence to Thrive

Earlier this week, I had the pleasure of presenting to a group of professional women about emotional intelligence. They had chosen the topic and while it’s not my typical area of expertise, the idea interests me. At its core, emotional intelligence is about examining how we understand and interpret our feelings, our motivation, our interpersonal interactions. I think this is one of our lifelong jobs as human beings: to grow through self reflection and introspection.

So how does that growth occur? First, we need to have a basic understanding of how much emotional intelligence we already possess. As with all psychological concepts, there’s some debate in the psychological community about how measurable EI is. (There’s debate in the community about literally everything, to be fair). That being said, it’s pretty well accepted that emotional intelligence can be higher or lower depending on a number of factors: empathy, for instance, as well as motivation, social and self awareness, and self regulation. There are tests you can take online to get a feel for where you land in each of those aspects. Or you can take a moment and just consider: how well do you know yourself?

The reality is, honest self assessment can be tough. We all want to believe we’re naturally empathetic and intuitive, etc. But actually looking inward takes a little more work and a lot more humility than a standard, “how nice a person do you think you are?”. It takes effort to honestly face yourself and ask, how empathetic am I? How much do I let my emotions dictate my actions? What would others say about me?

A lot of my work as a therapist is encouraging people not to be so hard on themselves for having difficult feelings. So don’t get me wrong: this shouldn’t be an exercise in self flagellation. Rather, I want to encourage you to consider measuring your EI as one more way to grow. It’s all grist for the mill, as my brilliant clinical supervisor told me recently. How we understand and manage our emotions impacts our lives in numerous ways, big and small.

And if you aren’t ready to look further right this minute, you have permission to leave it alone until you are. Part of being emotionally intelligent is setting limits, even (especially) with yourself. When you are ready, I encourage you to investigate with curiosity and empathy. The path to growth doesn’t need to be all thorns. Celebrate the parts of yourself that bring and spread joy and tend to the parts that want to grow with love and compassion.

Why a home visit?

Mental health care looks a lot different these days then it did decades ago (though some things are frustratingly the same but that’s a post for a different day). For people my age and younger, it’s pretty acceptable to see a therapist, online or in real life. In fact, over the past two years, more people than ever have sought out mental healthcare. Not only that, they’re vocal about it. Which is wonderful! Mental wellness should be for everyone; there's no shame in caring for yourself that way.

But for the majority of my clients, who are from an older generation, therapy is still something to be whispered about, not shouted. Many of my clients have never spoken to a therapist before. As a result, they’re a little overwhelmed by sitting down with a stranger to spill their deep, dark secrets.

This is where the home visit really shines.

There is a natural power imbalance between a therapist and a client, no matter how we both may want to pretend we’re on equal ground. The client is in a vulnerable position, about to answer some really personal and difficult questions; the therapist holds a lot of power in that situation. But when I enter your home, I am first and foremost your guest. This evens the playing field immensely. In your private, comfortable space, I am a visitor and you get to make the rules.

For many of my clients, meeting at home helps them open up faster. There are literal objects to point at when they begin to feel stuck, for instance: a wedding photo or a trinket from a long ago vacation. There is the comfort of being in your own safe space as we begin the hard work of feeling better.

So while it may seem strange to some that I don’t have a physical office, others are relieved to hear that they don’t have to go anywhere; I’ll come to you in the place you feel most comfortable. The only expectation is that I’ll show up, we’ll sit down, and you get to talk. How easy is that?

The Fragility of Hope

Sometimes my clients tell me, explicitly or implicitly, that they don't believe they will ever feel better. They are almost entirely without hope. They cannot imagine that their current circumstances will ever change. As their therapist, I want to validate that feeling because it is a real fear. But I also want to help them envision a future without the pain they’re currently experiencing. This doesn’t mean meeting them with platitudes or promises; it means meeting them in their despair and offering them a little light. When they can’t see the possibility of something better, I tell them that I can. Sometimes, I hold the hope for them until they can hold it themselves.

One wonderful perk of seeing a therapist is that the relationship between you is part of the work. You may not believe in your ability to change, but your therapist does. The moment you show up to therapy, you have taken a step towards feeling better, even if better looks or feels really far away.

This is not to say getting there is an easy or pleasant process; it’s often really difficult. But that’s the other great news about therapy! You have to do the work, sure, but not alone: your therapist can help you share the burden. And if you feel stuck in your suffering, your therapist can hold the hope that things will change; that you can change.

If you are struggling or despairing or feeling lost, please know that you are truly not alone. Someone is out there, waiting to hold on to hope for you until it is in your reach again. Just step forward and ask.

"I shouldn't complain; it could always be worse"

There are many phrases I would like to strike from the English language but these two, which are often coupled together, are currently at the top of my list: “I shouldn’t complain; it could always be worse.”

Now listen: I’m not here to deprive you of a helpful coping mechanism. If taking perspective works for you in times of crisis, have at it! But let me challenge you a little by asking you if it really does help.

Sometimes clients say this (or some version of it) because they are tired of having difficult feelings. Their problems begin to feel endless and frustrating; they are stuck. They aren’t looking for perspective so much as minimizing their own experience out of guilt and frustration. Specifically, in a time like this, when the world is full of worst case scenario stories, people are more likely to feel bad about “complaining.” When the news is full of the horrors of war, there is a tendency to minimize our own tough stuff. After all, if you’re safe in your home, with your relative comforts, it’s easy to feel guilty for feeling bad about anything. Of course things could be worse.

But they could also be better. Others’ suffering does not alleviate our own. There is no comparison chart that shows us when we are allowed to complain. Certainly you can count your blessings; in fact, there’s a significant body of research that posits that beginning the day with a gratitude exercise improves your mood. That’s great news! But still, even if you practice gratitude, you are allowed your own moments of sadness; of disappointment; of regret and complaints. You are allowed to experience your feelings without qualifying them with “it could be worse.” You can acknowledge the suffering of the wider world while also making space for your own little corner of grief. I’ll sit there with you until it gets better.

The grief "to don't" list

After a death, people seem to think that there’s a grief checklist, a list of tasks to accomplish that lead to your grief being over. The person dies, you have a funeral, you’re sad for awhile, then you have to “move on,” whatever that means. Sometimes well-meaning family and friends decide that it’s time to help move things along. They start asking, “when are you going to donate all those clothes?” or, “don’t you think it’s time to get rid of the reading glasses?” They want you to rid yourself of the physical reminders of what you have lost as if that will help you “move on.”

Great news, though: you don’t have to get rid of anything. The people who are telling you this don’t understand that the clothes and the pictures and the glasses aren’t preventing you from getting over your loss. For some of us, keeping those things around is like having an anchor. There’s a reason we have cemeteries and shrines and altars to the dead: we want something physical to go to, to be near, to hold, so we can grieve.

After my mom died, a pair of her slippers stayed by the door for like, four years. I could not bear to move them. She had left them there, thinking she would be back to slip them on when it was cold in the house. She had touched them; that made them sacred. After awhile, the spell was broken and they were put to use by other feet. I can’t tell you why it changed; it just did.

This is all to say, there’s no rush to get rid of the stuff. You are not stuck in your grief if you aren’t ready to clean out the closet or put away the pictures or take off your wedding ring. On the contrary, you are moving through your grief by experiencing it. Some well-meaning (but very wrong) person may soon ask, “when are you going to get rid of all this stuff?” When they do, you can answer, “when it’s time.”

Carrying the weight of grief

Grief brings its own kind of exhaustion. Clients often tell me that they think they’re getting enough sleep—they’re going to bed at a reasonable hour and sleeping through until the morning, minus the usual up-to-pee-at-3-in-the-morning—and yet they still feel tired all the time. Why is that, they want to know? Often it’s the weight of their grief, holding them down even as they try to move through the day.

I’m no somatic therapy expert but it’s widely accepted that our feelings show up in our bodies. It’s no coincidence that we describe being “gutted” or “broken-hearted” when something upsetting happens; we often feel emotional pain in a physical way. We cannot disconnect our minds and our bodies, no matter how we sometimes try.

Just like any other heartbreak, grief can show up physically: as exhaustion for instance, or a general achiness throughout the body. Sometimes you may cry so hard you become short of breath for a minute. We cannot ignore the physical pain and weight that grief exerts on us. So if you feel tired, headachy, occasionally short of breath, certainly check in with your primary doctor first. But after you get the all-clear, spend some time considering: is carrying the weight of your grief hurting you?

This is not to say you’re doing grief wrong. All the ways you grief manifests are normal, if awful. Rather, I hope you take away that if you are suffering, you are not alone. No one can take your pain away from you but others are willing to help you carry it. There is no burden you have to shoulder alone, even (especially) your grief. This is your invitation to reach out—to a friend, a lover, a stranger, a therapist—and let someone else share the weight with you.