Grief Series - Episode 1

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Transcript

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You're listening to Vital Signs, a podcast for Sentara providers. Welcome to episode one of the grief series.

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In today's episode we're joined by Tommy Bateman, director of clinical Practice management, and Peggy Hames,

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licensed clinical mental health counselor. Before we turn things over to the team, here are a few important CME announcements.

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This episode is accredited for AMA PRA, Category 1 credits. For full accreditation,

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designation, and disclosure information, please refer to the show notes. And now here are Tommy and Peggy.

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Hello and welcome to Vital Signs, a podcast for Sentara providers. I'm Tommy Bateman, your host,

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and to this, uh, during this episode series, we're gonna be talking about grief, it's complications, how to treat it,

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how to see it. And with us today is Peggy Hames, LC

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oh LC, what was it? LLC what?

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Licensed clinical mental health counselor. That is much better than all the acronyms. Thank you so much, Peggy.

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Um, Peggy, I really appreciate you coming today. I know you have a lifetime of experience, uh, working with grief,

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working within yourself and making yourself a more, uh, integrated and whole provider in the,

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in the grief space. But before we get started about all that, can you tell us about yourself?

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Sure, um, uh, I have a private practice in North Carolina, uh, which I've had for over 20 years.

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I also had the great gift of being invited by Elizabeth Kubler Ross's staff to train with them.

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She did intensive grief workshops, so I trained with them and then was invited to work alongside them in those workshops.

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And when they retired, I was part of a group carrying the workshops forward,

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so I've been doing grief workshops around the country for about 20 years.

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And so,

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Thank you for that. And, and when, when people talk about grief, you know, among the population,

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there are people have different definitions. What would you say is a, I guess a first basic definition of grief,

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one that kind of encompasses the, the whole spectrum, and then let's get down to the nitty-gritty about, uh,

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other aspects of it.

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I think it's most basic grief is the response to the loss of something that has been connected to our hearts.

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And that may be a person, it may be a pet. Um, and maybe something else completely different,

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um, that doesn't fall into those categories, but something with which we had a heart connection.

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And yeah, sometimes it's grief for what we dearly wanted but never got to have.

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So

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As you, as you're saying, I, I, I think of, I'm thinking of trauma right now where, you know, people always think people with PTSD,

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well, they went to war or something or had some horrible thing happen to them, you know, you, you, you name some sort of catastrophe,

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but PTSD can develop from all kinds of different events, it, it really is different for each person and I'm,

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I'm hearing that it could be different for, um, in grief as well.

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Right. And, and that last category, grief for what we didn't get can be hard for people to give themselves permission to grieve.

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They say, well, I got a good life or I got these other things.

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But if it's something that mattered to you, it matters. Um, people who suffer trauma as children and abuse as children may

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need to grieve not having the childhood they should have had, a safe childhood.

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Uh

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Couples who struggle with fertility issues grieve the children that they were never able to have,

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or the relationship with a parent you, that you really wanted and weren't able to have.

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Those are all very real losses.

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I was also thinking of, uh, special needs parents of special needs children,

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you know, they're grieving the life that they're, they still have their child and they love their child, but they're grieving the life.

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Perhaps we can't go out to restaurants like we wanted to. We can't, we're grieving the life that we didn't get,

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and that's not a selfish thought, right?

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Right, and, and that's one of those things we, we tend to talk about grief like this very.

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Discreet orderly thing and it isn't. And like with a special needs child,

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there is a lifelong grief that when all of their friends are hitting milestones,

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whether it's going off to first grade or, um, going to college or,

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you know, different milestones of life, that their child may never achieve.

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And so there's a grieving and some years it may be gentle and some years it may be really hard.

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But there's a grief that comes along with that.

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Now, clinically speaking, sometimes we talk about the difference between, oh excuse that, the difference between,

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you know, complicated grief and normal grief. So, grief is a normal part of our life,

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we're gonna experience it. Sometimes we need help getting through it, sometimes we are able to do it, um,

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especially if we have a community around us. What, what's the difference? What's the line between complicated grief and normal grief?

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Let, let me give you an example of, of, um, uncomplicated grief.

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Let's call it that. Um, one of my Kubler Ross friends, one of my dearest friends in the world,

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died, uh, this past summer at 93.

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And we had a deep and rich friendship. Now, I grieve her loss and I miss her tremendously.

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And every day I think of something I want to tell her.

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But

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Our friendship was such that there was nothing left unsaid.

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So it was all clean, you know, and, and there's, there were no regrets,

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uh, and there was no what, what Kubler Ross called unfinished business between us.

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So

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Could a, could a, could an appropriate word be something like healthy grief? Is that, is that a, a proper category?

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Well,

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I, I kinda, I kinda hesitate on that because then, then we start judging. What I, I, I find is people really judge their grief.

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People are afraid that they are going to flunk grieving or they're not doing it the right way.

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So I think it's like uncomplicated, you know, you have a parent who lives a good,

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healthy, long life and you had a great relationship.

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You may grieve their passing and miss them tremendously, but there's no other stuff wrapped up in it.

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Uh, uh, sometimes grief becomes complicated, one, because the relationship is complicated.

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Uh, you may have a parent whom you dearly loved, but also was emotionally abusive in some ways.

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Mhm. That gets complicated.

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Um, you may have a grief from the past.

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That impacts your loss in the present. That sometimes we don't grieve because we don't have the luxury of grieving.

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If you're a parent and your spouse dies, you're, who is the primary breadwinner,

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And you have kids at home.

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Sometimes you don't have the luxury of, of grieving. You have to survive.

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But the grief we don't attend to doesn't go away.

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So you may have a present-day loss.

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That all of a sudden you realize you're not just grieving that loss, you're grieving the loss of your spouse or the loss of a parent or,

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or whoever that you never had a chance to grieve before.

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So it always comes out like, uh, uh, a common thing in therapy is if, you know, something that you don't address will always come out somehow,

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some way in the long run and I'm, I'm hearing grief is the same way.

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Right, and the image I use is that grief, the, the losses we have.

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Are like links in a chain.

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So if you pulled on one link in that chain, the rest of the links are gonna come too.

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Right, OK.

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How does, and, and I know it's different for every single person, but how does,

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uh, uh What does grief look like, you know, how does it come out?

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an image I like is that that grief is an energy, it's like a river.

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And so it needs expression.

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Now, real commonly that they may find expression in crying, you know, that to release,

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um.

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The day I had to put my beloved dog down, I, I was in a worship service that morning and I just wept

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to the house because that's how my grief was coming out.

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Um, it may come out in anger and, and being really short

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with people. Uh, when my, I think it's when my dad was dying and I went by the grocery store,

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and I remember looking around and thinking, what are all of you people doing here? You know, my dad is dying and my life is changing.

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How can you be looking for the perfect tomato? Right.

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Uh,

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You know, sometimes it's manifest in sleeping too much, sometimes not sleeping at all,

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eating too much, not eating at all.

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Um,

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One of the things I've heard commonly from people is just I wanted to put all of their pictures around.

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I want to have those reminders.

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Other people don't, don't want any reminders. It's too painful.

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Um, so it's, I, I guess we could say in general if you now want to say in general,

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it's a constellation of feelings.

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And They may be chaotic. Um, and Lamont used the images like the wheel of Fortune wheel that we,

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you know, we stop in one moment, we stop on, on anger or sadness or whatever.

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I've amended that as I've thought about it, that the wheel of Fortune wheel, it's as if those,

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um, those slots, those labels changed as it was spinning. So, you think you're going to stop on sadness,

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but it's actually something else.

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And we can go,

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yeah, so on, on that like it.

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Sometimes, uh, uh, doctors can, uh, they have 1015 minutes, sometimes less with an individual.

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A nurse has a little bit longer. What, you know, a person comes in for X medical condition,

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right? Um, what are some physical or medical issues that may arise out of grief that that doctors may be able to recognize?

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Uh, inability to sleep.

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It's a big one, or inability to focus.

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Uh, you know, doctors would talk about chemo brain, the, the fuzzyheadedness of,

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of people going through chemo. Well, grief brain.

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It's actually the same, same kind of thing is inability to focus, like,

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I just can't remember things. I don't know what's wrong with me. I just can't get anything done.

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Um,

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I did fuzzyheadedness.

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Good, uh, big changes in eating patterns, uh, changes in social connections.

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Uh, one thing that doctors may see is when an older person.

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Is moving like into an assisted living or a continuing care community.

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Which they may be very excited about, they may be ready to do it.

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And it, it can be a huge, huge grief. So to ask.

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The, the place you're leaving, did you raise your family there?

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Mhm, mhm. Because they may be living in the place where their kids' heights are marked on the door frame.

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And that's a loss.

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Mm.

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So, I think that's a good place to stop on for this, for this episode, and everyone,

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when we bring Peggy back, we're, we're gonna talk about more about what she just finished on, uh, how to assess for grief,

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what that looks like, and really also, uh, recognizing it in yourself. So thank you, Peggy.

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Thank you for joining us. Be sure to keep an eye out for episode 2 of the grief series.

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You've been listening to Sentara Vital Signs, a podcast created for Sentara providers.

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As a reminder, please check today's show notes for details on how to claim your continuing education credits.

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That's it for now, but we'll be back soon with another episode of Vital Signs, the podcast that delivers evidence-based education

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for physicians and healthcare providers on the go.