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TLC
ARTICLES
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“Freedom is a power within Expressing Desire to Action. Not for the Faint-Hearted, It is a strength that forms and flows from life itself. Elemental truth without which we remain in a maze of fear and limitations Enchained to Death.” Marvin R. Rubin |
When I asked my father to write his thoughts on freedom, he unhesitatingly wrote the above. I chose to elaborate on this theme of freedom as an inner power that only we can imprison by our fears of change and death. To deny death is to impose limitations on our life and our culture, creating “reality” based on short-term vision and immediate gratification which can leave us spiritually bankrupt. The pioneering work of Dr. Elisabeth Kubler-Ross in the field of death and dying, and Dr. Raymond Moody with his transformation research in near-death experiences (NDE) have profoundly affected people in confronting their fears of death and increased their hopes for survival of consciousness. Close encounters with death and NDE may awaken us deeply to our spiritual life purpose and to an appreciation for loving unconditionally. In doing so, we accept the impermanence of all physical life. And in turn, life becomes more precious. This timeless awareness can set us free from the limitations of the past. It can speed up our desires into acts of self-healing and compassionate service for the “greater good” of others and the planet. Empathy, compassion and love form a resonance between living things, making it possible for the mind to transcend the limits of the body, time and space, according to Dr. Larry Dossey, M.D., author of Healing Words. For those of us who have not had such stark awakenings, we can still learn from weathering losses and mini-deaths that force us to let go of who or what we are attached to. Suffering often accompanies loss of relationship, one's health, or a job or the death of a loved one. Similar to physical death, the ordinary mind disintegrates through this suffering; all that we have identified with ceases to exist. We are alone with our emptiness and this freedom is initially so foreign to us that we resist, trying to cling to the past, out of fear. It is helpful at such times to have what Richard Moss, M.D., author of The Black Butterfly, describes as an “unobstructed relationship” with self or another in which to “embrace the unknowable and pass through the doors of our (individual and collective) aloneness”. As a psychotherapist working with thousands of people grieving death, I have seen the effects of devastation on the human being. Bodies record the shock. Minds relentlessly churn and rework the past again and again, searching for reason. Hearts cry silently or out loud. Yet, I have also seen the creative power of the spirit within; the natural transformative potential which, like a bud. in winter, awaits patiently to awaken to its purpose, coaxed to life from death. Or it may just as easily come from an impetuous quickening that propels us to radical aliveness bom from our undoing and humility. Here we realize the freedom inherent in the elemental truths of the universe. From the subatomic world, forms dance in and out of existence, fearlessly. Change is forever creating life from death and vice-versa. Our freedom does not come from outside us. It lies within. It is our soul calling forth a revisioning beyond the personal. It is reverence for what is sacred. |
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Over the past decade, I have received over approximately 100 hours of professional training and have worked with numerous clients using a therapeutic method called EMDR (Eye Movement, Desensitization and Reprocessing). I have witnessed hundreds of dramatic healing effects on client's behavior, emotions and changes in perception, related to their trauma as it impacts their lives. However, it was not until I had a life threatening injury, where my neck was broken in a car accident that I really internalized the benefits of the EMDR process. During the first month while I was still in terrible pain and shock, the strongest symptoms of Post Traumatic Stress that I suffered were specific dizziness and swerving motions every time I thought of our Jeep flipping over or while watching Jeep Cherokee commercials on TV. In place of any emotional feelings, these reactions randomly intruded on my daily thoughts and images. Carol Crow, a therapist friend offered to do some EMDR sessions at my home. At the end of the second session I was no longer hovering over or stuck in the images previous to, during, and after the crash. The mental recycling that kept me imprisoned to the scene altered, allowing the stored emotional trauma and sensations to move through my nervous system and be digested. The relief I felt was immeasurable. Yet, the greatest gift of healing was the total absence of the swerving motion when I recalled the accident or saw TV commercials. The changes were dramatic. I could begin to let go of feeling “broken in pieces” and return to my body’s need for inner healing. One year later, I returned to the physical scene of my accident in Utah, and lay to rest the remaining pain that was left inside me and on the earth. What I've described is similar to the kinds of traumatic events that threaten one's very core and overwhelm ordinary coping defenses, resulting in intense fear, helplessness and loss of control. Trauma is timeless. The event could be recent or years ago. The reactions of PTSD occur in two very different behaviors. In the first response, the person cannot separate or get out of the trauma, reliving the original event through nightmares, flashbacks, panic attacks and obsessive thinking. In the second, the person cannot allow the event in, instead choosing to avoid, by staying busy, numbing out or substance abuse. In either case, physical symptoms can include insomnia, panic attacks, heart palpitations and hyperarousal, the tendency to be easily startled by any reminder triggering the trauma, (e.g. the sound of an ambulance siren or other sound, sights, smells, or feelings). According to Francine Shapiro, Ph.D., originator of the EMDR process, research findings show that when someone is negatively affected by trauma, information is stored in the motoric (body systems) memory, rather than narrative (verbal) memory. The negative emotions and physical sensations of the original event are locked inside the nervous systems, producing intense feedback reactions and symptoms. EMDR has dramatically helped to accelerate the healing process as it applies to grief, when a person gets stuck in the images, feelings and interpretations about the death or dying scenes, whether real or imagined; sometimes, the survivor was not physically present and had to rely on second hand information regarding their loved one's death. As a therapist, I explore with the client their most disturbing images, beliefs, thoughts, sensations and emotions. After this assessment, EMDR protocol is followed. The client is then introduced to the process of bi-lateral stimulation through a variety of ways: eye scanning, auditory sounds, or kinesthetic gentle tapping motions, designed to help move through and release conditioned responses to trauma. |
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Every time youth violence occurs in a community, parents, teachers and counselors throughout the nation ask themselves why did this happen and how could it occur in our neighborhood schools. There is never any complete answer. Experts can, at best, make psychological judgments based on the motives and profiles of teenage killers, yet it is impossible to know exactly how and when the line of thought and fantasy crosses over into blatant annihilation of innocent lives. Young students and their families who witnessed the horror of the Columbine High School tragedy have relived it in nightmares and flashbacks similar to the experiences of any witness of crime or traumatic loss victim. Police, EMS, fire and rescue teams and the media also experienced first hand individual and collective trauma. The models for permissible grief in our society are rare. In one U.S. school incident where kids were gunned down by two of their elementary school classmates, community leaders asked residents that day to “begin the healing process” and “move on with their lives.” How afraid we are of pain! Children killed children. It is hard enough to take in that fact. Though the loss and pain had barely begun to be realized, people were encouraged to move away from their grief and sorrow. As an expert in traumatic grief, it is apparent that many of the effects of traumatic loss and death have far-reaching implications. Many witnesses of crime seen at The LIFE Center who do not show their grief emotionally, often have somatic complaints and may function on automatic pilot or speak of “being numb or deadened to pain.” They often describe feeling disconnected from their bodies and their world. It is little wonder that such depressed energy can be dormant for years, if not treated as post-traumatic stress reaction. The stressors for these adults, children and professionals, as well as for TV viewers who have experienced similar trauma, can be triggered by any sight or sound such as: the image of a body on a stretcher, the sounds of mass crying, gunshots or ambulance noise. Any of these reminders may stimulate the body’s fight/flight response. The emotional impact, buried in the body memory at the moment when the news first hit, is re-experienced. The use of a therapeutic technique such as EMDR ( Eye Movement Desensitization and Reprocessing ) has been a valuable tool in helping reduce the immediate traumatic images and memory flashbacks that intrude on a client’s present thoughts and actions. It is vital that trauma survivors with prolonged symptoms seek professional help so that they can fully grieve and heal. Through a generous grant from the State of Florida , Victims of Crime Act (VOCA), The LIFE Center is continuing to provide trauma relief counseling to survivors of crime incidents, DUI deaths and murders. It is my belief that whenever our community or nation is stunned by violence or disaster, we may experience our own world wounds that render us more vulnerable, and yet at the same time, offer an opportunity for healing. When horrible, unfair things happen, we may equally witness the humanity of people reaching out to help others across great barriers and distance. Such heroic acts of compassion help to deflect the injustice of random chaos. Out of the chaos, collective grief gives rise to consecrated places where every person’s expression of love and loss is honored. One does not need to go far to see the sacred spaces erected where once stood unbearable tragedy: the Oklahoma Bombing decorated wire fence; the TWA crash site monument; Princess Diana’s grave; the Vietnam War Memorial Wall of Names; the Holocaust Museum; the Native American Trail of Tears March and the Aids Quilt are some examples of these tributes. And in our own backyard, candlelight vigils, MADD crosses, personalized markers and rituals all symbolize the named place where the event and the last breath was taken. The sharing of our world wounds is interpersonal and universal. Healing is a long stretch of the imagination from the counterpoint of trauma and tragedy. Yet, some hopeful light is shed whenever I witness in others the courage to grieve, to live with the unanswered questions and to release the scenes that cause a resurgence of suffering and guilt. Inside the darkness, there is a wisdom to still choose life, and one day perhaps, to know the peace that softens sorrow. |
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The loss of a friend, family member or loved one can be overwhelming for anyone, but by being part of a strong support system you can play an important role in his or her healing process. Being a great listener is a given, but by recognizing and understanding the complexity of the emotions of grief you will be in a much better position to help someone through the healing process. The History of the 5 Stages - are they appropriate? Many doctors, clinicians, and caregivers still use the following stages as milestones for the bereaved. Yet for those struggling with the loss of a loved one, the idea that grief recovery follows a standard timeline of set stages can seem ridiculous, if not infuriating. Certainly those who have had to heal from a painful loss are well aware that the process doesn't fit in to neat little boxes. These five stages were originally outlined by Elizabeth Kubler-Ross in her 1969 book On Death and Dying, and referred to the steps that a terminally ill patient may go through upon learning of the finality of their situation. These five stages synthesized what caregivers had witnessed in dying patients from studying their coping mechanisms. The stages at that point were not yet known as the 5 Stages of Grief, but rather “The 5 Stages of Receiving Catastrophic News.” Since then, these stages have morphed into what is commonly known as The 5 Stages of Grief: Denial - This isn’t happening; this isn't real. Anger - Why has this befallen me? What have I done to deserve this suffering? Bargaining - If I can get out of this, I promise will be a better person. Depression - I don’t know what I’m going to do. I don’t care anymore what happens to me. Acceptance - Okay. This is real, and I’m ready for whatever I have to go through. How long is too long to be grieving? On the surface, these 5 Stages of Grief seem sensible. And when the world is spiraling seemingly out of control due to grief, these stages may provide a certain comfort in their structure. But the idea that everyone could go through the same stages at the same time and in the same order led to the early notion that those not following the standard progress of grief may have a pathological form that needed professional help. Worse still, if the bereaved weren’t completely through the stages by a certain time, some might be treated as if their grief was out of sorts or inappropriate to their situation. More recent efforts have been underway by bereavement researchers to look at how people grieve over time. Synthesizing several grief theories, Jacobs (1993) presented a hypothesized set of responses to grief that expanded the stages: 1. Numbness-disbelief 2. Yearning-anger-anxiety 3. Depression-mourning 4. Recovery Recent studies (Bonanno, Wortman, et al 2002; 2004) have also highlighted several distinct recovery paths, and found that normal grief reactions persisted even eighteen months after the loss occurred. Testing the theory that grief occurred in stages, a 2007 study (Maciejewski, Zhan, Block, Prigerson,) found that participants whose partners died due to natural causes simultaneously felt all of the stages of grief to various degrees at each time point measured, with the feelings of acceptance being greatest even at the beginning when a person was closest to the loss, and this acceptance increased over time. And while many might feel that depression/sadness would be next on the list, yearning was the next most frequent response reported throughout the study. This last study highlights a significant fact: anger and depression do not have to be the defining, lasting features of the grief process. It's important to note that this study raised controversy when it was first published because all of the grief indicators were in decline by six months after the loss, and the authors implied that further evaluation and potential referral for treatment may be necessary after that time. But the timeframe for the course of normal grief and adjustment could last much longer, with survivors incorporating positive memories into their lives years after their loss. Carnelley, Wortman, Bolger and Burke (2006) found that widowed respondents continued to experience memories and even participate in conversations about their deceased loved one beyond the first four years after the loss. Contrary to popular belief, this was a normal response to the loss of a loved one, not inappropriate attachment or dependence. This was also a sign of good adjustment when participants were able to focus on the positive aspects of memories of their loved one. They also found that “anniversary reactions (i.e., painful reminders of the loss during a specified time/reminder)” were sometimes experienced for decades, with the intensity of these reactions dropping quickly in the first few years. While these might be considered a setback in recovery, it’s important to emphasize the commonality of such reactions (infrequently as they may be) as a normal response in the grief process, not a pathological one. In fact, respondents of a study by Harvey and Hansen (2000) reported that they frequently engaged in “account making and confiding:” talking about their previous relationships with their new partners and /or close others as a way of coping with the loss (although this was used more by women than with men). Many emphasized the positive impact this had on their well being. So if your partner continues to discuss memories and tell stories of the deceased well after the loss, do not despair it can be a normal part of the healing process. How to help those that are grieving The grief work premise is that those grieving must confront and express their emotions in order to fully heal from their loss. Most who are familiar with grief work would say that people should reflect, process, and express all that is coming forth regarding the loss of their loved one. But researchers have found that disclosing grief isn’t always beneficial. Stroebe and colleagues (1996; 1997, from Pennebaker 2001) found those that were asked to disclose their grief through writing didn’t differ in the physical or mental health after a one year follow-up. In another study, family members were rated by those grieving as less helpful than friends (Marwit and Carusa 1998). Obviously this is an intense time, and many factors need to be considered when helping those affected by grief and loss. Being sensitive to the type of loss, overall impact, and, if you are involved your own feelings of grief, may improve your support to those that are grieving. For instance, death due to an unexpected event versus a long-term, painful illness might elicit different reactions from survivors. In the case of a partner passing after a long struggle with a terminal illness, the survivor may have already worked though some of their grieving during the time of their partner’s illness. In addition to grief, the survivor may also feel relief that their partner isn't suffering. But when a partner has died suddenly and unexpectedly, talking about the loss and processing the feelings can be beneficial in coming to terms with the event. When an intimate partner dies, it’s quite possible to set off a crisis of the entire support system, and friends and family may have difficulty providing support to a partner because they are grieving themselves. Other researchers found that outsiders may be unaware of the full magnitude of the loss, with changes in financial security, emotional support, practical help, and so forth for the survivor. Death can elicit powerful feelings that might overwhelm the surrounding survivors with tumultuous and vulnerable feelings, and often not knowing what to do, those genuinely trying to help might create more harm than good. Wortman, Wolff and Bonanno (2004) provide culled evidence of three behavior types that can be detrimental to the bereaved: 1. Discouraging open expression or discussion of feelings about the loss 2. Encouraging recovery 3. Falling back on clich'd or scripted support attempts that trivialize the bereaved issues. What is beneficial is allowing survivors the opportunity to talk about their feelings on their own terms. Expressing concern without pushing advice, as well as reaffirming the presence of support (without necessarily forcing it) is also helpful. If you’re unsure how to approach the situation, it might be best to take a cue from your partner in how open and willing they are to talk about the loss. Finally, talking with others in a similar situation (e.g., a grief support group) is also thought to be beneficial. Grief Work: Moving Beyond the 5 Stages The Counseling for Loss and Life Changes group (TLC) suggests that grief work actually begins where the last “stage” of acceptance leaves off. A common definition they use is summarized by the acronym TEAR: T = To accept the reality of the loss E = Experience the pain of the loss A = Adjust to the new environment without the loss R = Reinvest in the new reality If you know someone who is grieving right now, make sure they understand they can come to you on their terms. If you are struggling with how best to support them, sometimes asking then “What can I do that would be helpful to you?” or “What do you need from me?” may get a beneficial discussion started. If you are grieving and would like to seek professional help yourself, pick a counselor who is trained specifically in grief intervention work, and if something isn’t working for you, be sure to let them know. Complicated grief does exist, and if you feel you are experiencing thoughts and emotions beyond what is considered “normal” try reaching out to a trusted doctor, clinician, or caregiver for more information and support. While interventions and therapy can be appropriate for some individuals, it isn't necessary for everyone. Sometimes the best way to heal is just by accepting that adjustment and recovery go beyond five easy stages. Those closest to you can be a great source of support. References and Further Reading: Counseling For Loss & Life Changes (1997). Article 8- Beware the 5 Stages of “Grief.” Retrieved June 7, 2007 from http://www.counselingforloss.com/article8.htm Carnelley, K.B., Wortman, C.B., Bolger, N., & Burke, C.T. (2006). The time course of grief reactions to spousal loss: Evidence from a national probability sample. Journal of Personality and Psychology, 91, 476-492. Harvey, J.H., & Hansen, A.M (2000). Loss and bereavement in close romantic relationships. In C. Hendrick & S.S. Hendrick (Eds.), Close relationships: A sourcebook (pp. 359-370). Thousand Oaks, CA: Sage Publications, Inc. Jacobs, S. (1993). Pathological grief: Maladaptation to loss. Washington, D.C.: American Psychiatric Press. Maciejewski, P.K., Zhang, B., Block, S.D., Prigerson, H.G., (2007). An empirical examination of the stage theory of grief. Journal of American Medical Association, 297, 716-724. Marwit, S.J., & Carusa, S.S. (1998). Communicated support following loss: Examining the experiences of parental death and parental divorce in adolescence. Death Studies, 22, 237-255. Pennebaker, J.W., Zech, E., and Rime, B (2001). Disclosing and Sharing Emotion: Psychological, Social and Health Consequences. In M.S. Stroebe, W. Stroebe, R.O. Hansson, & H. Schut (Eds.) Handbook of bereavement research: Consequences, coping, and care (pp. 517-539). Washington D.C.: American Psychological Association. Wortman, C.B., Wolff, K., Bonanno, G.A. (2004). Loss of an intimate partner through death. In D.J. Mashek, D.J.,& A. Aron (Eds.), Handbook of Closeness and Intimacy (pp.305-320). Mahweh, NJ: Lawrence Erlbaum Associates. |
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