Anxiety- The Missing Stage of Grief

by Claire Bidwell Smith

  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, let’s move on to the next chapter in which we’re going to begin thinking about positive changes we can implement in our lives as a result of loss.

  6 | Taking Inventory

  What would you do if you weren’t afraid?

  —S HERYL S ANDBERG

  W HILE CHAPTER 5 WAS ABOUT EMPLOYING A RESILIENT-GRIEF approach to picking up the pieces of your life after a loved one dies, I want to take it one step further in this next section. In this chapter, we are going to look at the ways in which anxiety manifests when we ignore the call to reevaluate our lives after losing someone significant.

  Grief never fails to serve as a reminder that our time here is short and that we truly must make the most of it. But grief can also come with a dizzying sort of freedom. It can help you realize what is important and help you focus on living your best life, but, even so, sometimes those things are hard to do, and the anxiety comes from knowing you’re not doing them.

  Finding a balance between embracing life to its fullest potential, and also being responsible and planning for the future, is an important part of this journey. Don’t be surprised if you have found yourself in this predicament—suddenly wanting to make major changes to your life because you now realize what is truly important to you. Or—sometimes harder—you know you need to make major changes but feel paralyzed. In this chapter, I’m going to check in with several different clients and authorities about how they approach this issue.

  Dr. B.J. Miller, who drives a motorcycle despite being a triple amputee and who displays very little anxious traits, had this to say when I asked him if he experiences anxiety. “I was going to say no, right off the bat, but I do. I experience anxiety when I ask myself if I’m making the best use of my time. Am I loving life as much as I could or should or would? Am I doing things that I believe in? In a way, the fear of death is really the fear of not living the life I want to, while I have it to live. If those are one and the same, then yes I do have anxiety about death.”

  Evaluating these epiphanies about the potential to live your best life is vital to moving forward and rebuilding your identity without your loved one and to overcoming all the anxiety that comes with doing so. There are many approaches that will allow you to tackle this in a positive and meaningful way. I’d like to begin with the story of my client Ethan, because his journey to fulfillment is one I aim to achieve for all of my clients—and for you.

  ETHAN’S STORY

  Ethan booked his first appointment with me following an acute panic attack at work. After puzzling over what could have brought it on, his only guess was the recent loss of a friend. The loss of this friend had resurfaced an even older loss—that of his father when he was a teenager, and now Ethan was in his thirties and felt he was finally assimilating the devastating impact of losing a father in a way he never had before.

  At the time he came to see me, Ethan had suddenly found himself aware of the ways in which his father’s premature death had affected his self-esteem and his ability to be emotionally intimate with his girlfriend. But it was the death of Ethan’s friend that acted as a catalyst, helping him see that now was the time to finally make some changes.

  Losing a friend so close to his own age had served to remind Ethan of just how short life can be, and this set off a wake-up call, resulting in a series of debilitating panic attacks. Ethan realized that he wasn’t living the life he wanted to be living, but because of buried grief over his father and the dissatisfaction of his career and relationship, Ethan suddenly felt panicked and paralyzed about what to do about it.

  Over the course of several months, Ethan and I worked closely together to untangle all the threads of grief. Pulling these apart was necessary in order to really understand the results that had come from these losses. While it was Ethan’s friend’s death who had served as the wake-up call, it was really the grief over Ethan’s father that we needed to work through.

  Largely because he had been a teenager at the time of the loss, incapable of grappling with the complex emotions of grief, and also because he’d had to step in as the male figure in the household, Ethan had never truly allowed time or space to process his grief. Thus, it manifested in a variety of ways that directly affected his ability to be emotionally intimate. Additionally, Ethan carried a lot of anger and rage that would sometimes burst forth in unexpected situations.

  Although it was easy for me, as the therapist, to see that we needed to backtrack through his father’s loss in order to tackle his underlying anxiety, each week Ethan came in feeling frustrated with his day-to-day life and wanting to focus on that. He was miserable in his job as an attorney—a career he’d felt he should pursue but had never been passionate about. He was also deeply unhappy with his long-term live-in girlfriend and did not feel that they were compatible. While she was pushing to get married, he longed to find the strength to break up with her, but the truth was he was afraid to be alone.

  Ethan’s panic attacks grew stronger before they got better. He experienced them frequently at work, and sometimes in the morning upon waking up. He told me that at first he would be feeling fine and going about normal tasks, and then suddenly he would feel swept away by a wave of dizziness that would serve to trigger his entire adrenaline system, sending him into a spiral of shallow breathing and lightheadedness. Each time this occurred, he felt certain that he was going to die, and his whole life—and in his mind a life yet truly lived—flashed before his eyes. Several doctor visits and multiple tests all reported him as in perfect health. By the time Ethan came to see me, he had developed anxiety simply about having more attacks.

  I urged Ethan to work with me on several levels. The first was normalizing his anxiety, by giving words and context to it. The emotions of regret, fear, and anger were so bottled up within him that the only outlet they could find was these attacks. His thoughts were creating emotions that sent his body into a series of fight-or-flight responses.

  Many of my sessions with Ethan began by discussing his current life circumstances and the changes he was intent on making, followed by concentrating on opening up his old grief about his father’s death and all the ways that loss had impacted his life. None of this was easy for Ethan. He had spent nearly two decades trying to pretend like everything was fine. Acknowledging that perhaps the opposite was true was very painful for him initially.

  I reviewed the suitcase analogy that I’ve spoken about earlier in this book, explaining to him that it can be difficult to open up his metaphorical suitcase and take a look at all the long-buried contents but that together we would sift through it and begin to rearrange, discard, and add better coping tools. We worked on checklists of things to do in the midst of a panic attack. I taught Ethan about meditation, even walking him through it during our sessions, and helped him incorporate a daily practice in his life. (Meditation will be covered extensively in Chapter 9.)

  While Ethan worked on his own time to adopt these new coping methods of meditation and mindfulness for his anxiety, and also began to have a series of painful yet necessary talks with his girlfriend, we began to spend more time in the office processing the grief over his father’s death.

  In one session I helped him walk through the painful memories of his father’s actual death—a sudden heart attack that Ethan had witnessed, the memories of which he had long since buried. Digging these up and letting him feel the pain and sadness was difficult but rewarding. He was able to express and verbalize his fear, sadness, and trauma around this event and take it out into the light of day to let it breathe a little. We carry these memories around in us, whether we are even aware of it or not, so taking time to reflect on them and process them in a safe place helps ease some of the weight we carry with them.

  We also worked to examine all the impacts this loss had on his development. He�
�d developed an avoidant attachment style as a result of this traumatic separation from his father, and it contributed to his lack of ability to be emotionally intimate with his partner. When we experience major losses early in life, it often affects our way to attach to other primary figures in our lives. Instead of being able to hold secure attachments, we can develop anxious or avoidant styles that limit our capacity to form healthy relationships.

  Over the course of a few months, Ethan’s anxiety began to dissipate considerably. Learning new tools and also processing his grief had softened him, allowing him to open up his full range of emotions rather than bottling them up. As he began to find himself on more solid footing, Ethan turned to the next task at hand: taking charge of his life.

  Ethan’s biggest fear was that he would also die young like his father did and not have lived the life he meant to live. So, in addition to beginning to make changes, we talked a lot about his thoughts about death and about what happens when we die.

  Ethan realized he had never really let himself explore these ideas. He didn’t really know what he thought about death or about the afterlife. We had many a spirited conversation about these topics, and Ethan began to explore various religions and aspects of spirituality that began to bring him comfort and peace. (For more on this process, see Chapter 10.)

  Ethan’s panic attacks ceased two months into therapy. While he began to feel better emotionally, spiritually, and physically, more than anything he now felt driven to take charge of his life and make the big changes he had been afraid to make. He worked to open up to his girlfriend and discovered that he didn’t want to break up with her but wanted to explore a deeper emotional connection—one that he had previously been incapable of.

  Ethan also made drastic changes to his career. He quit the law firm where he had been so miserable, and he started his own firm, helping immigrants in need of low-fee counsel. He also began playing the guitar again, something he had abandoned in adolescence, planned a trip to an exotic location that he’d always wanted to visit, and enrolled in an art class as a way to tap into a creative side of himself that he felt deserved attention.

  By the time our sessions came to an end, Ethan was in a completely new place in life. He had a new career path and was saving money to buy an engagement ring for his girlfriend. He was much more emotionally stable, and his panic and anxiety had diminished to almost zero.

  Taking inventory of your life after losing someone you love is an important part of the grieving process, but it’s also a very significant way to reduce anxiety. As you saw in Ethan’s story, a loss can serve as a wake-up call, reminding us of our priorities and sometimes alerting us to ways we’ve been living that aren’t optimal.

  There is often a fear, though, that moving forward means letting go of your loved one, and I want to continue to reiterate that this is not the case. You can move forward and live a meaningful life while continuing to honor and cherish your person. Two things can be true at once: you can miss your person and wish they were still here and also build a new life without them.

  This forward movement has a different time line for everyone, so I urge you to find the right time for yourself to do this work. Sometimes we push ourselves to move on too quickly as a way of trying to escape the sadness. And sometimes we steep too long in the sadness before finally finding a way to move forward. Check in with yourself, and even check with friends and family to see where they think you are with this.

  TEMBI LOCKE’S TIME LINE

  I remember getting to the first anniversary of Saro’s death and feeling like I had been duped. Somewhere in my psyche I thought that if I could just get through the first year, just be as present as I could, then I would start to feel better. But I arrived at the end of that first year, more exhausted by the idea that I had more years of grieving him to come. I didn’t feel better, I felt more lost than ever. And I was managing my own grief and our daughter’s grief alone. Parenting a grieving child can put one’s own grief on a whole other trajectory. It was a heart-wrenching time.

  That second year was just about waking up and allowing myself to be in the world as it was. It was prayer each night, meditation in the morning. Put one foot in front the other. Sit down when needed. Then try again. I remember being disillusioned that year, which I think was my form of anger. And I was also terribly anxious that year. I had many, many, doctor visits. I was sure that there was another diagnosis waiting in the wings. My grief had become physicalized. I felt sick all the time. And my daughter’s anxiety about losing me fed into my anxiety. It was a terrible loop that took me months, maybe a year to get out of it.

  It was perhaps at the end of the third year when I began to see the evidence of a new life that I was building. By then, I had enough experience with my own grief to know all the events and triggers that would cause me a deep sense of loss. But I also knew how to handle them a bit. I had developed some support system and “tools” for self-care. And by self-care, I mean just knowing when to bow out, take a personal day, go easy. I had learned to take my hand off the wheel when I knew I was skidding on the black ice of grief. I had to release and surrender in order to allow the moment to pass and get back on safe ground. That year is when I began to want to find an instrument for grief, a way to turn my loss into something beautiful and meaningful.

  In the fourth year, I began to get curious about my life, the bigger things that I wanted and desired. I wanted to reclaim parts of me that had not only been lost in grief, but that had been lost in years of caregiving. I had desire again, professionally and personally. I became curious about dating, I started a professional endeavor that opened doors for me. Life felt scary but also filled with potential. My own potential. I had done enough hard grieving that my energy source was refilling again. My anxiety abated somewhat.

  And now, in the fifth year since his death, I feel his loss in a different place. It comes to me daily, but in a different way. Not less acute, his absence can still leave me overcome with sadness. But now, I am more familiar with the way the grief rolls in and rolls out again. I have had time to develop a relationship in death and with my own heart-felt loss. But that has taken five years.

  I would suggest that it’s actually a process. And for me that process moved (and still moves) at varying paces. My resilience is actually my willingness to show up in the face of the unknown, without promise. When people look at me and see resilience, they are really looking at someone who struggles to stay open and curious to life. And certainly, I do feel that seeing women (and men) who have suffered the loss of a spouse or a child or a sibling and seeing that they have managed to carve out a life from loss inspires me to find my own way. I always ask people how they do it, what has worked for them. Other people’s bravery is the fuel and inspiration for my own resilience.

  As you read through the following list of questions, try not to feel overwhelmed. You may have strong reactions to all of them or maybe just a few. Either way, facing all the parts of our lives that we need to change can feel daunting. But remember that recognizing what those changes need to be is the first healing step. Once you’ve targeted the areas for growth, then you can begin to work on them in bits and pieces rather than all at once.

  Questions to Ask Yourself

  1. What are some things in your life that you would like to change? Job? Family? Finance? Are there steps you could be taking to begin to make changes in those areas? Is this the right time to make these changes? Consult with friends, family, or a therapist to evaluate the answer to this question.

  2. Do you have any bad habits you need to quit? Overeating? Smoking? Alcohol? Many people use short-term behaviors like drinking, drugs, redecorating, rebuilding, sex, eating, and social media as temporary distractions from the pain of grief. Finding ways to work on reducing or eliminating these habits can be a great reliever of anxiety and guilt. There are many support groups and specialized therapists that can help you eliminate these behaviors.

  3. Are you involved in relationships tha
t either need to end or need to change? Review the people you surround yourself with and ask yourself if they are contributing to your life in meaningful and healthy ways. If they are not, seek ways to shift those relationships.

  4. Do you need to make amends with someone? Is that weighing on you? Revisit Chapter 4 and open yourself up to healing any broken ties.

  5. Do you have major life goals (writing a book, running a marathon, learning a new language) that you have been putting off? Perhaps now is the time to consider embracing and working toward these goals.

  6. Ask yourself Sheryl Sandberg’s question: What would you do if you weren’t afraid?

  7. Are you contributing to the world at large? Take stock of any ways in which you feel you are doing so (volunteering for a nonprofit, donating to causes, helping people in need), and think about ways you can increase or incorporate these activities into your life. Finding ways to feel like you are living a meaningful life is a great way to reduce anxiety about your place in the world.

  8. What are the positive things that you can do because your loved one is gone? Make a list and work to embrace them.

  WHY DO WE GET INTO UNHEALTHY RELATIONSHIPS AFTER A LOSS?

  This is one of the most common themes I encounter with my clients. It is not at all unusual for people to either commence or perpetuate unhealthy relationships following a loss, but these relationships can also become one of the largest sources of angst and anxiety.

  Unhealthy relationships can sometimes begin immediately after a loss, or they can become a pattern that plays out for years, so whether you are new to your grief or you are processing an older loss, taking a look at how it plays out in your current relationships will be a key component to creating a healthier lifestyle free of anxiety.