Anxiety- The Missing Stage of Grief

by Claire Bidwell Smith

  But in the beginning, that was my story, and I was sticking to it. Another part of my story also was that the doctor didn’t do enough to save my mother or that there was more that could have been done. Although I knew that her cancer was diagnosed very late in the game.

  So in doing the research, I got my mother’s medical records. And I saw in them that the social worker, in the hospital after the surgery, tried to tell her how bad it was, and she didn’t want to hear it. I also interviewed her oncologist, who was actually a really nice guy who’d been sort of, like, the evil physician in my mind. He turned out to be such a nice man. He said to me, “Hope, there was never any hope of saving your mother’s life when she came to me. The best I could do was buy her as much time to be with her children, and that was my goal. I knew from the start I wasn’t going to be able to save her life. It was too advanced. It had spread too far.”

  When I heard this, I was just like, wow. And initially, I had to sort of retreat into my little cave and process this new information. But then I think the most significant moment came after that. I went down to Florida to interview my mother’s best friend from childhood who I’d stayed in touch with all those years. When she heard my version of events, she said, “Hope, I don’t think you’re giving your parents enough credit. I knew your mother really well. I’ve known her since she was thirteen years old. And I’ve known your father since they were dating.” She said to me, “I don’t think your mother wanted to know. I think your parents had an either spoken or unspoken agreement that your dad would give her the news and that he knew what she could handle and what she couldn’t.” She said, “I think if your mother had known the truth, she would have died much quicker. I think it actually gave her more time to not know.”

  Well, finding all this out was so powerful. Because now I had to change my story! This story of mine had been a very self-righteous one, a story of self-victimization that had given me a lot of power, and now I had to change it. I’m so glad I did because it helped me understand the whole situation from a much more mature, adult perspective. But it was disorienting and a little disabling for a while. I needed to sort of make meaning out of that. I needed to sort of fold it into the previous narrative and let it change.

  I could have said, “No, I’m not going to accept that.” I could have been really stubborn about it, and some people are. But in doing the research, I had to be sort of ready to accommodate whatever that new story meant. That old story was my buffer against sadness. I had to be ready to let that sadness happen. So this isn’t really a story about anxiety, but about sadness.

  As you can see in Hope’s story, it’s easy to make our stories suit our emotional needs. This is not a bad thing; it’s a coping mechanism. Oftentimes, we are in such deep emotional pain following a loss that we are capable of doing only the best we can. And sometimes the best we can do is tell ourselves a story that helps us get through the day, the month, that first year.

  The problem comes when a decade later we realize that we are clinging to a story that is not entirely true and that is, perhaps, harming us on a deeper level, causing anxiety or anger. As Hope said above, her story was less about anxiety and more about sadness, but for so long she was afraid to steep in the sadness, so she pushed it away, letting anxiety take control.

  It can be daunting to do this work on your own, so I do suggest utilizing the help of a therapist or trusted friend who can help you look at all the components of your story. I’m also going to provide some questions below that will help you take a look.

  In thinking about when to do this work, Hope suggests, “I think everyone is ready at a different time. Some people are going to be ready to do that search very quickly. And for some people it’s going to take a lot of years. Everyone is on their own path. That information will be there when they’re ready. Not forever—some of the people or materials may be harder to dig up, but whenever you’re ready is the time to do it. But I couldn’t put a time stamp on it. The one thing I’ve learned in twenty-five years is that there’s no one-size-fits-all for grieving.”

  QUESTIONS TO ASK YOURSELF ABOUT YOUR STORY

  Below are a few questions to ask yourself when thinking about your story. Do this work on your own in a journal or use these questions to bring to your therapist or confidant.

  1. What is the beginning of your story?

  There are many different beginnings to our stories. Consider that there are various ways to think about the beginning of your story. Is it when you were born and your life began? Is it when you heard a loved one’s diagnosis? Is it the moment a loved one died? Is the beginning of your story the beginning of when you accepted the loss? Let yourself consider each of these as a beginning, and ask how that changes how it plays out.

  2. Are there parts of the story you leave out when you tell it?

  Owning the whole story is an important part of this process. If there are painful moments or if something happened that you wish you could change, don’t leave them out. Instead, examine them and see what work you need to do around owning and accepting those parts. Again, finding a safe person or environment in which to delve into these aspects is important.

  3. Are there parts of the story you are telling that are perhaps not true in the way you once believed them to be?

  Remember that our stories are always changing. Different life experiences as well as maturity lend themselves to seeing our lives and experiences in new lights. Recall how Hope Edelman thought her mother was deprived of medical information, and when Hope learned the truth, the story changed. Are there ways you can open up to the idea that maybe there are parts of the story that you are ready to reconsider or explore in a new way?

  4. If the story you are holding on to is centered around the person’s death, can you expand it to be more about their life?

  In the beginning, we often cling to stories about the death—the events or illness leading up to it, the final days or moments, the immediate aftermath. Imagine using a camera lens to zoom out so that you can begin to look at the entire life of your loved one, not just their final weeks or months.

  5. Is there a version of this story of loss that depicts a positive experience?

  Sometimes we need to turn our story inside out, or we need to squint our eyes and look at it like one of those negative-image paintings, focusing on the parts we are not always seeing. View your story through all the positive things that have occurred as a result.

  In On Grief and Grieving, Kübler-Ross and coauthor David Kessler acknowledge the need we have to share our stories with family and friends. “When someone is telling you their story over and over, they are trying to figure something out. There has to be a missing piece or they too would be bored. Rather than rolling our eyes and saying ‘there she goes again,’ ask questions about parts that don’t connect.”

  That’s exactly what we are trying to do when we tell these stories—connect the missing pieces and make sense of what has occurred. Please do not deny this natural impulse. This is an intrinsic piece of the puzzle and how you will navigate your way through the grief process to a more healing place in life. Recognize that you have an important story to share, and strive to find safe outlets in which to do so. Letting this story out, and fully understanding it, will ease all that you are bottling up, helping you release tension and anxiety that have built up as a result.

  OTHER PEOPLE’S STORIES OF LOSS

  In the initial phase of grief, you may not feel ready to hear other people’s stories of loss, but eventually they can become greatly comforting and very healing. By reading or hearing other stories of loss, you will realize that you are not alone. You are not alone in going through this major life event, nor are you alone in all the feelings that come with it.

  Reading about how other people navigated through their grief process can help you find your way. Additionally, realizing that other people faltered along the way, or felt guilt and remorse in regards to their loved one, can help you begin to forgive yourself for yo
ur own shortcomings.

  However, do not feel as though you have to listen to or read any stories that do not feel good to you. Feel free to put down a book or put off attending a bereavement group until it feels like it will be helpful.

  HEALING MEMOIRS ABOUT LOSS

  Wild by Cheryl Strayed (mother loss)

  The Year of Magical Thinking by Joan Didion (spousal loss)

  Her by Christa Parravani (sibling loss)

  Invisible Sisters by Jessica Handler (sibling loss)

  A Grief Observed by C. S. Lewis (spousal loss)

  Truth and Beauty by Ann Patchett (loss of a friend)

  The Long Goodbye by Meghan O’Rourke (mother loss)

  Wave by Sonali Deraniyagala (loss of spouse, children, parents)

  The Light of the World by Elizabeth Alexander (spousal loss)

  The Angel in My Pocket by Sukey Forbes (loss of child)

  H Is for Hawk by Helen MacDonald (father loss)

  The Guardians: Elegy for a Friend by Sarah Manguso (loss of a friend)

  Heaven’s Coast by Mark Doty (spousal loss)

  The Still Point of the Turning World by Emily Rapp Black (loss of child)

  GET IT OUT

  Sharing and exploring these stories are ways of coming to terms with the loss. Going over the details of a loved one’s death helps you face the reality of it and begin to accept the loss. Again, this doesn’t mean that you are letting go of your loved one or that you are “over” their death, but instead you are working to face the loss.

  According to Kübler-Ross, “You must get it out. Grief must be witnessed to be healed. Grief shared is grief abated. Tell your tale, because it reinforces that your loss mattered.”

  A NXIETY C HECK-I N

  Let’s check in with your level of anxiety. In the last chapter, we learned about storytelling and how it affects both our grief process and our anxiety levels. When we can find an appropriate outlet for everything we are carrying around after a loss, we can also ease the pressure that builds.

  Finding ways to acknowledge your story and release the burden of holding on to it will be an important part of decreasing your anxiety.

  Rate your current anxiety level on a scale of 1–10 (with 10 being the highest).

  1 2 3 4 5 6 7 8 9 10

  Check the symptom boxes that currently apply:

  Panic attacks

  Insomnia

  Nausea

  Dizziness

  Heart racing/palpitating

  Obsessive worry

  Hypochondria

  If you are experiencing regular panic attacks or obsessive worry, skip to Chapters 8 and 9 to begin learning how to calm your anxious thoughts. Otherwise, continue to the next chapter, where we are going to learn about how to work through any guilt you may be feeling following your loss.

  4 | Making Amends

  “No regrets” doesn’t mean living with courage, it means living without reflection. To live without regret is to believe you have nothing to learn, no amends to make, and no opportunity to be braver with your life.

  —B RENÉ B ROWN

  A MONG THE MOST COMMON EXPERIENCES FOLLOWING A LOSS IS that of guilt and regret. I have yet to meet a grieving person who does not harbor some feeling of remorse over something left undone or unsaid in the wake of losing someone they love. It is only natural that this happens, yet it is also one of the underlying causes of anxiety.

  Elisabeth Kübler-Ross states, “Guilt is perhaps the most painful companion of death.” And it’s true that these feelings of guilt can be all-consuming and often debilitating. When death comes to someone we love, it feels as though a door has been forever shut. Words and actions left undone may play out in your mind for months, or even years, following the loss. But there are ways to work through these painful regrets. There are still ways to make amends.

  Often we attempt to push away everything that is left unspoken between us and our loved one because we feel that there is no way to make amends now that they are gone. But when we resist the impulse to find closure, it festers inside of us and gives us a feeling of unease. Not consciously realizing where that uneasiness comes from creates a feedback loop of anxiety. Truly processing all the guilt and regret is vital to diminishing anxiety.

  I know that this work might feel scary. The things you regret or feel guilty about are probably the ones you push away the most. Or they’re the ones that arise most frequently, causing you undue amounts of anxiety. I know this because I grappled with my own guilt for so many years, and I also know this because I see it in every single one of my clients.

  I have been the recipient of so many confessions of guilt that it is impossible to count them all. These confessions most often occur deeper into the therapy work. It is rare that they emerge in the initial sessions, and that is because these feelings are the hardest ones to talk about. Only once a client has become extremely comfortable do they finally begin to open up about the guilt and regret they are carrying.

  It’s always remarkable to me, though, how healing it can be to simply voice your regrets out loud. Usually, when we think of something we wish we could have done differently, we immediately shove it away, telling ourselves that we can’t change it and thinking that it will make us feel worse to think about it. But I believe the opposite is true. We need to acknowledge our regrets and guilt and then find ways to process them, make amends, and forgive ourselves.

  So let’s begin by openly diving into it all. Let’s open the windows in your heart and shine some light on these dark feelings. First of all, I want you to understand that you are not alone in any feelings of regret, remorse, guilt, or shame. Everyone who experiences loss feels regret of some kind, whether it is warranted or not.

  Guilt is an interesting concept. There is a version of it that is therapeutic and useful. In this version, we recognize that we have done something wrong and understand that we must learn from our mistakes and become a more fully evolved person. But when someone is gone and it feels as though there is no way to make amends, this dilemma becomes more complicated.

  When we experience guilt within grief, we feel forced to carry the burden of our wrongdoings with us rather than being able to apologize and make things right with that person, feeling that we are no longer able to do so. However, holding on to guilt is counterproductive to our healing process and serves to cause undue amounts of anguish and anxiety.

  Working through your guilt, no matter how scary that might sound initially, will be one of the keys to alleviating your anxiety.

  There are so many ways that guilt comes to us. Mostly, it is for things we did not say or do during our time with that person. Sometimes it is for things we simply wish we could have done differently.

  REASONS FOR COMMONLY FELT GUILT

  Not being there at time of death

  Not saying good-bye properly

  Unrecognized anger (at the person or ourselves)

  Survivor guilt

  Not apologizing for something

  Not doing something that could have prevented the death or suffering

  Behaving poorly toward the end

  Having negative thoughts about the person

  Feeling relieved about the death (usually after a long illness, mental or physical)

  Not spending more quality time together when given the chance

  Taking the person for granted

  PROCESSING SUDDEN LOSS

  When we lose someone suddenly or unexpectedly, it is almost impossible to escape feelings of guilt or regret. There is often much left unsaid between you and your loved one, not to mention many feelings of regret over actions taken and not taken on both parts. Anger often plays a huge role in the processing of sudden losses. You may find yourself angry with your loved one, with others who you believe could have prevented the death, and also with yourself.

  When we dig deeper beneath the anger, guilt usually surfaces. We may find ourselves feeling guilty for being angry at our person or feeling guilty about something we d
id not do to change the outcome. Admitting these feelings and letting yourself process them openly will help to soften them. Pushing them away will do the opposite and create that feeling of unease that leads to anxiety.

  It is very common to have recurrent thoughts of how we could have changed or prevented the death. In most cases, these thoughts naturally recede after a period of weeks or months, but sometimes we need to enlist the help of trusted friends or professionals to help us resolve them. Our brains often take time to adjust to the new reality of this person being gone, and for a period of time it not unusual to find yourself trying to think of ways that things could have played out differently so that you do not have to face this new reality.

  Many people try to stop themselves from playing out these alternative scenarios, but really it’s just the mind working its way to a level of acceptance. If you feel that you are obsessing on alternative scenarios in a way that feels unhealthy, please do seek the consult of a therapist who can help you.

  A client of mine named George lost both of his parents in a sudden car accident. When he came to see me, he had recently had two panic attacks that seemed to come out of nowhere. He told me that during the first one, he had been on a camping trip with his wife and small children and that the second one had come at work while he was sitting at his desk.

  George considered himself a very strong person and was angry that he was experiencing this kind of anxiety. He was reluctant to admit that it was connected to his grief, but at the urging of his wife, he had reached out to me.

  As we dug into his story of loss, he confessed that he’d had an argument with his father about financial matters shortly before the accident, but they had never resolved it. George was consumed with guilt that he had not been able to apologize before his father died. He felt as though he could not even let himself grieve because he was so angry with himself. He spent his days pushing all of these thoughts and feelings away each time they arose.