A Remarkable Recovery From Unspeakable Grief and PTSD

512px-Pedra_do_Baú_-_Campos_do_Jordão_-_São_Paulo

Some stories stick with you. The word “heartbreaking” is not enough to describe them; nor do “resilience,” “survival,” and “overcoming misery” say enough.” Yet all those words apply.

The therapist in the tale who helped enable a positive conclusion was Donald Meichenbaum, Ph.D. He related this account in a video focused on finding meaning in the aftermath of trauma: PTSD & Complex PTSD: Ways to Bolster Resilience. 

Don’t read further if you wish to avert your eyes from tragedy, but understand this: you cannot know of the treatment that allowed for a redemptive, healing story unless you face it.

The woman: a young, bright, intelligent mother. A good mother. Her husband was away on a business trip. Home held only her daughter and herself. An intruder could be heard downstairs. Mom entered Vicky’s room and they hid in her closet. The burglars left without going upstairs. The event upset both Vicky and the mother, worried such an episode might happen when the husband/father traveled once more to make his living. The adults installed a security system and alerted the police. They lived in a safe neighborhood. No reason to expect another forced entry. Still, the man insisted his wife get a gun, just in case. She did not like firearms, but relented. The night stand next to her bed harbored the weapon.

Time passed. The man traveled again. Late and stormy darkness. Noises downstairs. Was the mother dreaming, reliving an imaginary or remembered version of the home invasion?

No. No. No. Not again.

Yes, again.

The mother urgently reached for the gun and moved toward her bedroom door to go to Vicky’s room, just as she had the first time. Vicky came running and pushed the mom’s door open. It struck the mother’s hand and the firearm discharged. Vicky died immediately. The mother sat with her dead daughter for 24-hours until the husband returned.

No words are possible. The parents’ lives were forever changed. Guilt, horror, marital separation, grief, depression. Even loving friends became unavailable, unable to bear the story. Alienation and isolation. As the mother saw it, a life not worth living. She deserved to die.

What is a therapist to do? He can never undo the tragedy, but perhaps he can help the survivor to find a reason to live, a meaning for the rest of her life. Here is what Meichenbaum did:

The psychologist knew his job was first to establish a therapeutic alliance, to show compassion, and accept, not judge. He needed to allow the patient to tell her story as she was able, permit its unfolding, not push. A plan to prevent the woman’s self-harm was created. The therapist allowed his emotions to be touched. His own tears came as he listened.

The psychologist asked a question to understand more about the loss. The client had said that Vicky was “special.”

In what way?

She was wise beyond her years.

The first session ended and the doctor arranged a second appointment in two days’ time. Meichenbaum made a request. He said he would be “honored and privileged” if mom brought in a photo album of Vicky, but only if she wanted to: no pressure. He wished to get a further sense of who the child was.

Reviewing the pictures together was painful in the extreme. Yet this marked the beginning of the doctor’s effort to embed the only moment the mother focused on (the accident and death) within a broader narrative of Vicky’s life and her own life: to pull his client out of the single instant of horror into the stream of her ongoing existence — perhaps to create a potential redemptive story projected into the future.

This is not to suggest any kind of treatment would ever erase the pain or guilt completely. Yet, it might still be possible to help the mother give Vicky’s memory meaning. And perhaps to transform the patient’s life in the process.

The therapist asked his client another question. Two, actually. He wanted to know what this child (who was “wise beyond her years”) might say to the parent’s wish for oblivion:

What advice would Vicky give and what would happen to the memory of her if you kill yourself?

The mother affirmed the obvious answers which had escaped her: Vicky would not want her to die. Moreover, the memory of Vicky would also die with the death of the one who knew her best. Meichenbaum’s questions led her to realize she might do some good in the world, something to perpetuate Vicky’s memory and give meaning to the child’s short life. Treatment continued. Mom became a public advocate for gun locks and gun safety, thus transforming her loss and honoring Vicky.

In part, Donald Meichenbaum assisted the patient to fashion a new story of her own life different from one ending with two deaths. She became aware her time on earth was not yet completed. And that Vicky’s impact on the world offered a potential future, if only the parent gave her daughter a metaphorical life — gave voice to what her daughter’s death could still achieve.

This is not at all to suggest the mother wouldn’t have traded anything — anything — to get Vicky back. Yet, the mom might yet continue her existence with a constructive narrative of redeeming value in spite of complicity in the child’s loss.

Meichenbaum is famous for asking questions — for creating a Socratic Dialogue with his patients. He did not give his patient advice, but led the conversation so she might grasp the next rung on the ladder of recovery, not simply be handed it. Therapists should know “directions” from the counselor don’t produce as much “ownership” of the treatment process, nor as much motivation to change, as occurs when he helps the client uncover her own way, not just follow advice.

Might you also find your own way? Might the rest of your story be one of value?

What do YOU say?

The photo is titled Pedra do Baú — Compos do Jordáo. The author is Izabel Tartari and it was sourced from Wikimedia Commons.

Beyond the Loss of Someone You Love

Defense.gov_photo_essay_100925-A-3843C-147

When you have sustained a personal loss others provide consolation as best they can. If it is a death, there is a funeral to attend and a home to visit. If it is the breakup of a relationship or a marriage, there are phone calls, email, and visits, too. Plus, in almost all cases, an off-stage sigh of relief from the friend or relative who was not so close to the departed; relief that it didn’t happen closer to their heart and their home. But what is life thereafter for those who are most bereft?

You know some of it because you’ve lived it or read about it or seen it on stage: the tears and/or anger, the grieving process, etc. I’m not going into that which is well-known to most people, but rather some of the things you might not think about that happen when someone terribly close is gone; and how the life of one remaining behind can be changed. The items on the list may or may not happen to you, but they do happen, at least occasionally, for more than a few.

First, however, I want to emphasize that while we are not all the same in dealing with loss, the time it takes is usually measured in months, not years. That said, anniversaries of the death, holidays, and other significant events at which the departed is absent can be very tough, especially the first few times through. And the long shadow of an important life can reappear even years later, although without the emotional wallop, as a rule. Just to emphasize, this is something almost all of us get through, painful though it is. And, as you will see at the end of this essay, it can also be a thing from which you learn and grow.

Now to the less often discussed experiences that you might have while going through the grieving process:

  • Fatigue. Loss can be like a giant vacuum cleaner that sucks the life out of you. You may feel tired, need more sleep, or simply have a general lack of enthusiasm and joy. The sadness is well-known, the spirit-draining weariness is less frequently discussed, but can go on for months.
  • Dullness of Thought. Whether you have a razor-edged brain or the more ordinary kind, you just might find that your usual sharpness is compromised. Perhaps you will be more forgetful, perhaps slower to process ideas, or just less in command of the executive functions that your mind typically does automatically.
  • Seeing the Loved One Who is not There. The days will pass and you will usually do the usual things. Let’s say you are filling up your car with gasoline at one of those petrol stations that also include a convenience store, filled with some snacks and sundries. As you are staring off into space while holding the gas pump, you see your deceased father walking into the store to pay for his gas. You literally can’t believe your eyes, and yet it seems to be your dad. You wait for him to exit and, indeed, it is a stranger. For other survivors, a similar circumstance occurs when they hear the voice that is not there. These are usually not hallucinations, but simply a part of the survival and grieving process.
  • Reaching for the Phone to Call the One Who is not There. Something happens in your life that would normally cause you to call, or email, or text the person who is out of your life. Maybe it is news of sports or a personal achievement, a surprising event, or perhaps you want some advice. A second later you realize that the contact will be unavailing. It is either impossible, if the person is deceased, or unwanted, if your former love no longer wants you.
  • Thinking about What the Deceased has Missed. My Uncle Sam, who died at age 50 in 1970, loved technology. He was creative and made things with the digital dexterity of an old-time watchmaker, although that was not his craft. He was the first person I knew to have a tape recorder (big reels in those days before cassettes and digital recording), a window air conditioner, and a Kodak camera that gave you a photo seconds after you took it, an advance we now take for granted. He was also a rabid fan of the Chicago White Sox baseball team. Over the years, as technology has progressed, I have occasionally thought that he would have loved to live today to see and use it all; maybe even to play a part in changing it for the better. And, in 2005, when the White Sox won the World Series, he would have been in heaven. Then again, maybe he was.
  • The Inability of Others Who are also Bereft to Help You Grieve. The most poignant and difficult examples of this feature of loss come in families where a parent has perished or fled to parts unknown. If the family still includes a loving parent, the children are used to going to that mom or dad with their problems, assuming the kids are still relatively young. But now they find that the person who provided consolation is himself or herself laid low by the very same loss from which the children seek relief. Part of the reason that therapists are useful is that they have not been struck by the identical calamity and therefore have the emotional energy and perspective that the remaining parent temporarily lacks. In a way, the children of parents who are also grieving the same loss have sustained a double blow: the literal absence of one caregiver and the altered capacity and emotional support of the other.
  • Changes in Continuing Relationships. The demise or permanent absence of someone important can change relationships among the survivors. When a parent dies who served to block family differences and ensure that “everyone would get along,” those submerged conflicts can burst out. It is a bit reminiscent of the multiethnic countries of Eastern Europe or the Middle East who were ruled by a dictator, until the dictator was overthrown and sectarian strife broke out. In some other families — those where favorites were played by the parents — I have occasionally seen the passing of the parents permit the siblings to get over their grudges and become closer now that no one is present to “stir the pot” to a boil, setting one child against another. Then there is the departure of a central figure in a group of friends to another city. His or her loss can, in effect, be the loss of the glue that held the group together; or, it can be the opportunity to reform the group and perhaps add someone new.
  • The Death of a Child. This is the terror that haunts every parent who ever loved his or her little flesh and blood. Again, each situation is different, but I will comment on two possible outcomes only. Some folks effectively deaden themselves to their surviving children or to any new child who is born. Consciously or unconsciously, they are steeling themselves against the possibility of still another emotional wound. Blame, too, can raise its ugly face. If one or the other member of the couple believes that his or her partner “caused” the death by action, word, or inaction, the marriage itself is at risk. The suicide of a young person too easily sets off this chain of events. Yet it must be said that many of us have also tried to deaden ourselves after the loss of a romantic love. Time usually softens our hearts and fuels the courage to try again, but not always.
  • Meeting Someone Like Your Lost Love. My wife and I have made wonderful friends in the University of Chicago’s four-year “Basic Program” for adults.  One is a man named John Kain. For Aleta, John is more than a friend: he reminds her of her father, who died in 1968 before I had a chance to meet him. She describes John and her dad as “the kind of men whom everyone wishes to have as a friend, the salt of the earth.” Thomas Henek’s funeral drew hundreds and I am convinced he must have been the genuine article: someone you could trust, a person who believed in fair play, and an unprejudiced man raised in a prejudiced home; a man who lived a principled life with strong, but not inflexible opinions, a sense of humor, and, above all, the kind of guy you wanted to have next to you in war-time (he was in the infantry in WWII) — a buddy who had your back. Aleta says that talking to John saddens her not in the least, but makes her feel good because of his likeness to her father. Perhaps you will be so lucky after someone essential passes away, that years later you can, in effect, benefit from his likeness in a new relationship such as hers with John.
  • The Loss of Your History. We’ve all read history books with dates, statistics, events, and conjecture about what caused those occurrences. Usually historians wait a bit before writing books, in part because one needs some perspective to understand how the puzzle pieces interlocked and how the dominoes fell against each other before they stopped. Such books have the advantage of distance, but unless they are written by someone, now usually aged, who lived that history, one tends to miss the authentic voice of the person who was there. Moreover, written history does not take the form of a novel, and is necessarily more concerned with the big picture than those particular lives in which you or I might be most interested. Oral and video history projects, as well as photographs and home videos keep some of that alive. Yet, inevitably, there are things one wishes to know too late, even if you have interviewed an older parent or relative and kept the recording in a safe place. There are always new questions about times that were very different from the time we live in today. Parents and grandparents also are typically our only link to the days before video cameras were in everyone’s pocket.
  • The Undead Feelings about the Dead. In the superb 1970 movie I Never Sang For My Father, starring Gene Hackman and Melvyn Douglas, the first voice we hear is that of Hackman as the son of Douglas: “Death ends a life. But it does not end a relationship.” Such a death, where issues between child and parent were never resolved, finds the survivor struggling to heal himself alone or with the help of others, but with no ability to talk things through with his deceased progenitor. As a therapist, it was often my experience that my patients didn’t even know the extent to which they were still haunted by the neglect, criticism, or frank abuse of a late mom or dad. Indeed, on occasion, someone who was victimized only felt “safe” after the perpetrator’s death. Only then could her conscious and subconscious defenses drop enough to permit exploration and full awareness of the mistreatment she suffered. To some degree, there was still a small child within her (metaphorically speaking) who was terrified of what would happen if she talked about the thing she knew was never to be mentioned.
  • The Things You Said or Didn’t Say. Conscience can be a troublesome trait. Your words or actions — the things you believe you ought or ought not to have done while your parent was alive or your lover was still with you — are now put in “your permanent record,” as teachers of my grade school era would threaten from time to time about in-school misbehavior. This can happen even if your parents or your lover weren’t the best, but made you feel that it was you who were at fault. You will see this played out realistically in the movie I just mentioned, I Never Sang For My Father. If you cannot find the movie, read the Robert Anderson play of the same name, upon which it was based.
  • Unsolved Mysteries. Regardless of how much time you spend in therapy or hours on your own considering and reconsidering the actions and words of someone you loved — romantically or otherwise — more than likely there will be elements of understanding that elude you. Realize that you need to observe limits on how much time you spend reflecting on your past. You must live the only life you have in the present, regardless of what has been lost. As the great black Hall of Fame pitcher Satchel Paige said, “Don’t look back. Something might be gaining on you.”
  • Empathy. Though no one would choose to grow by experiencing loss, we tend to learn more from sadness than happiness, especially about the human condition. There is a depth that can come from loss and knowing that you can come out the other side. No life is clear sailing all the way. Losing a close friend, lover, brother, sister, or parent not only can enhance our ability to be kind to others, but also to be kind to ourselves. More than that, it silently speaks to the folly of believing that the accumulation of wonderful material things is more important than spending time with those you care about, while reminding us that those objects can be replaced, but a life cannot be.
  • Appreciation. A recent episode of the great TV comedy series, The Big Bang Theory, presented Bob Newhart as the ghost of the just-deceased “Professor Proton;” a man whose science show for children had inspired two of the program’s main characters, Sheldon and Leonard, to become physicists. Both of them had come to meet and know their childhood hero in his old age, and were troubled by his loss. Sheldon, when he is “visited” by the ghost, believes the Professor to have returned in the manner of Obie-Wan Knobe, the Jedi Master of the Star Wars films, who “lives” posthumously as a mentor and guide to Luke Skywalker. Sheldon is a brilliant but very self-involved and condescending young man, something the Professor is wise enough to identify. Proton responds to Sheldon’s grief with the suggestion that he begin to show appreciation to those still alive and around him while he can.

If there is any positive message in an ended love, I think the Professor had it right. The human heart does tend to heal, as the history of our shared humanity reveals. The danger is in ignoring the terrible fact that no one will be here forever. Loss reminds us to get on with life, to do what is most important, and to show and tell those we love just what they mean to us. Time sometimes is generous with us and gives us lots of opportunities. But Father Time does not put out printed departure schedules for the passengers on his train. We do not know when the wild and wonderful, up and down ride of life will end.

Don’t wait for the right time. The right time to show appreciation is right now.

The above photo is a U.S. Department of Defense photo essay taken by John Crosby. It is not about a permanent loss, but the emotion seemed to me to fit this topic. According to Wikimedia Commons, “U.S. Army Spc. Nathan Martin hugs his father a final goodbye before the 3-19th Agribusiness Development Team’s Afghanistan departure ceremony on Camp Atterbury Joint Maneuver Training Center, Indiana, Sept. 25, 2010. Martin, assigned to the Security Force Platoon, is saying goodbye to his loved ones one last time before deploying.”