Grief as a Hole in the Heart
by Edie Weinstein, MSW, LSW, PsychCentral.com
July 29, 2018

Today, I was speaking with a friend/colleague who has been a long time addictions specialist, thanatologist and grief counselor. Dr. Yvonne Kaye is an outspoken advocate for those who are living with loss. One of her specialties is working with bereaved parents, regardless of the age of the child or the reason for their death. She has been in the trenches with them for decades and never ceases to be amazed by their resilience in the face of what is considered to be 'out of the natural order of things.'

Compassionate Friends is one of the organizations with which she is involved and to which she refers family members and friends of those suffering such a loss. It was born 40 years ago as a result of a chaplain in England feeling helpless to assist two families in grieving the deaths of their children. He recognized the power of solidarity shared between those who had walked the path.

She shared a tidbit of wisdom from a bereaved parent with whom she had worked. The woman told her that although that type of inconceivable experience created a hole in her heart, she had learned to plant flowers in it. No one or nothing can completely fill the space, nor should they. She also reframes the concept that people often offer those who are grieving, that they need to be strong. Her take is that when you are strong, it means you don't need anyone. Rather, she professes, we all have strengths. I think of it as resilience, either hard wired into us or acquired as we mature.

At our birth, we enter into a world in which we experience loss. We are no longer living in amniotic nirvana in which all of our needs are met. From then on, it can be as simple as giving up a pacifier or a bottle as we move from infant to toddler or as painful as the death of a beloved animal companion.

Even as adults, that kind of loss has its challenges. Someone shared with me recently that with the death of a beloved pet who had been a family member for many years, she found herself tearing up when seeing his food bowl that needed to be washed, or knowing that if someone dropped a cracker on the floor, they would have to pick it up themselves, rather than waiting for their four legged cleaner to do it. She tends to submerge her grief, not wanting to feel overpowered by it. She also feels a need to protect others from theirs, in part because she wants them to be resilient. She expressed that she doesn't want to 'wallow'. My invitation to her was that she 'allow rather than wallow.' Let herself have all the feels and make room for those around her to do so as well.

We struggle to understand the concept of something "going away," and often there are no role models who are at ease with discussing the topic because they, too, may not have been educated in the ways of loss and grief. While there are books available on the topic, they don't take the place of first hand experience and the wisdom gleaned as a result.

Take a moment to contemplate the losses in your life and the ways in which you face them. Some people in treatment have faced the death of parents, grandparents, siblings and friends. If your emotions around these experiences were repressed - for example, if you were advised not to cry - you may have a well of tears waiting to overflow. If you were told that a person "went to sleep" or "went away on a trip," you might have feared closing your eyes at night or been fraught with anxiety each time a family member packed a suitcase.

These emotions may have lay dormant for decades and further held at bay by substance abuse. As we age, additional losses accumulate: job, physical vitality, cognitive functioning, children leaving home, financial challenges, and more. Each loss takes its toll on our well-being.

The Holmes-Rahe Stress Inventory incorporates 43 life events and a numerical rating scale of social readjustment for each one. Some of these life events related to loss include:

  • Death of a spouse (100 points)
  • Divorce (73 points)
  • Marital separation (65 points)
  • Detention in jail or other institution (63 points)
  • Death of a close family member (63 points)
  • Major personal injury or illness (53 points)
  • Being fired at work (47 points)
  • Death of a close friend (37 points)

When tallied up, these points indicate the risk of a major health breakdown, ranging from 150 points or less predicting relatively low risk to up to 300 points or more increasing the odds by 80 percent. Many of these events are to be expected in most people's lives, but when a person is living with an addiction, the odds are greater that incarceration, marital conflict, injury, illness, loss of job, and death of friends and family members from overdose will occur.

About "Loss Layers"
Although I've worked in the bereavement field for many years, I was introduced to the term "loss layers" when reading the book entitled Glad No Matter What: Transforming Loss and Change into Gift and Opportunity by author and artist Susan Ariel Rainbow Kennedy (also known as "SARK"). It was written in the midst of her mother's death followed by the passing of her 17-year-old cat and the ending of a romantic relationship. "Loss happens in spirals and layers and not in steps like a ladder," she says. The image that comes to mind is that of the child's game of putting one hand on top of the other and then moving the bottom hand on top of the person's hand above it until a tower of hands is built. We can only reach so high before stretching too far and need to step back.

Loss layers can also be visualized as a tidal wave of emotion. Before we have a chance to stand up from one loss, another wave heads in our direction and bowls us over. The natural tendency is to feel victimized or punished and want to stop the pain. But everything is a coping skill. If we have healthy and high-functioning coping strategies at our disposal - such as meditation, exercise, music, time in nature, being with supportive and loving family and friends, a spiritual connection, or whatever is meaningful to a person - there's greater likelihood of enduring and growing from the loss and its pain. But if the default mode of coping is substance use or another type of self-medicating behavior, the chances of feeling like you're drowning in both the loss itself and the consequences of the dysfunctional coping choice are increased.

Addiction recovery meetings, bereavement support groups, hospice programs, a compassionate and competent therapist, and pastoral support can help ease the sting of life's losses. Although we don't "get over" a loss, we have the capacity to move forward and embrace life, peeling back the layers of loss as we go.

As Dr. Kaye adamantly states, "Overcoming is not the same as getting over."