Good Grief

The experience of grief and loss is one that no one person living will ever avoid. I have learned though that how people grieve is as different as people are different. Many theorists have speculated on "how to" grieve or what to expect as "normal" when grieving. Elizabeth Kubler Ross, the Swiss born psychiatrist, is probably most famous for her theory that people with terminal illnesses go through five distinct stages of grief. She felt that we could expect the terminally ill patient to go through stages of denial, anger, bargaining, depression and eventually acceptance. Over the years, it has been accepted that it is not uncommon for the survivors of those who die of a terminal illness to also experience these same stages, as well as people who lose a job, go through a divorce or experience a major trauma. Critics of the theory say that it isn't as clean cut as going through these stages for many people as some people may never get angry or may never reach a stage of acceptance. Additionally, some people may move back and forth between these stages. It makes sense that as humans we are not predictable when it comes to an experience as complex as grief. The DSM (Diagnostic Statistical Manual, which is a manual for mental health professionals to use to make a diagnosis)is currently being revised for publication in 2012. "Complicated Bereavement" is being considered for addition for the updated version. Grief that lasts without a lift in its severity over time and/or that becomes so pronounced that it interferes with the day to day functioning of a person is considered complicated. There are of course certain situations that can complicate a grief process including series of losses in a short period of time, evidence of depression or other mood disorder prior to the loss, lack of social support and the way that specific person has grieved in the past. I agree that there might be situations where the loss of someone or other traumatic event may be a destabilizing event that disables a person from living their life as they did prior to the loss or event. I agree this might be out of the norm and considered a disorder that is treatable as a psychiatric diagnosis.
That last point though, the way a person grieves lingers in thought for me. I am more and more convinced that even though many people may cry at funeral services, memorials or upon learning of a death, many do not. There are some people who are in shock and literally cannot cry because the validity of the information that someone they love has passed away has not fully registered. I also know that there are people with personalities that just don't allow for crying, either it was a learned reaction or it is just their make up to present more reserved in the face of a major loss. At first glance another openly grieving person might label them as cold or in denial. What they might not know is that these are the people who might grieve privately and are not for whatever reason comfortable with an open display of emotion in public. Right or wrong? I say right. I say that no one person grieves right or wrong in comparison with another person. We are all programmed to manage our losses in whatever form they come, whether it is a death, divorce, illness, children leaving home, loss of youth, etc, in our own unique way. I truly believe that we cannot escape grief. We will feel loss somewhere on our life journey. I further believe that if grief goes unattended or stuffed down inside it will find its way out and sometimes in situations that are not congruent with the emotion. Take for instance the person who stoically goes through a divorce without emotion or processing of the loss out of a desire to get through it. It isn't uncommon for that same stoic person to break down crying when they come across a seemingly benign reminder of their marriage several months later. The lesson of course is to find your way to grieve, trust that it is a process, trust that it is "normal" to feel out of sorts for a while, and trust that your way to grieve is unique to you. No one can tell you how long it should take. No one should try to "distract" another from their grief, as it will only delay the inevitable and appropriate process. The moments in life that have grief as their backdrop are important moments. They show us our capacity to have loved and to have been loved, they show us our strengths and resilience, they also show us how fragile we are, how important today is and how unimportant all of the "other stuff" (think of your to do list) really is. Grief asks us to be present in our upset, it demands that we are attentive to what or more over who is left in our life and directs us to remember to live our life knowing that grief is a guaranteed and universal life event.
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Naming the blog

I decided to start a blog for my private practice to offer a portal to the process of psychotherapy. For decades therapy has been stigmatized, mostly by those who have never had therapy before or by people who are considering therapy and are still on the fence. I titled my blog “I’m not crazy–Am I?” because it is such a common question I get from new clients. They wonder if simply by going into therapy they are automatically branded by the mental health profession as “crazy”. I like to respond to that question with another question, of course I do, I am a therapist after all. I ask them what “crazy” means to them. For most of them they are feeling that they are one stressful situation away from being committed to a psychiatric unit. I let them know that I understand that is how they “feel” right now. I assure them that I don’t believe that they are “crazy”. Personally my definition of crazy is lifted from the 12 Step Recovery program, they use the word “insanity” instead of “crazy” but it is a definition that I believe is spot on. “Insanity is doing the same thing over and over again and expecting a different outcome.” Many of the people who come to me have tried to remedy their struggles alone or by confiding in a friend or family member and still are stuck in the same spot. They decide to come in and do something that makes them uncomfortable, sets them up for potential stigmatization from other people and moves them out of their normal means of problem solving by entering therapy. So, my pat answer for someone who is seeking therapy and wondering, “I’m not crazy–Am I?” I say, no, absolutely not.
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