Medical Minds Consulting | Victoria Silas, MD | Physician Coaching

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Honoring Grief's Season: A Guide to Embracing and Releasing Loss

This year I have become reacquainted with grief. Grief is not anyone’s idea of a desired companion. And yet, to be alive, to be in the world, to love, is to inevitably invite grief into your life. 

Grief is an interesting emotion. Unlike some which blaze and extinguish, grief rolls in and out like the tide, catching you off guard when you take your eye off it, it can slap you to the shore when a rogue wave hits you, unsuspecting and unprepared. 

We most commonly associate grief with the death of a loved one. (And anticipatory can grief make its entrance much earlier than the death itself.) Grief can also arrive after any significant life transition, more obviously after a status change like divorce, but also after seemingly joyful transitions like marriage, the birth of a long-awaited child, leaving school, starting practice, and of course retirement.  

After marriage, you may grieve your single lifestyle of sole decision-making. Becoming parents you may grieve your freedom. Leaving school or training can lead to grief for the more carefree days that came before your “real job”. Grief may be present when you one day leave the workforce. Indeed, I have a friend who cannot even contemplate leaving medicine. Who will he be without his doctor persona? 

Several years ago, a friend met me in the hospital hallways after his mother died. “My mother died”, he said. “I have no mother now.”

I looked into his eyes and saw sorrow. But also something else. I saw that the words “I have no mother” pained him even more than her death. And it was a lie. “Of course, you have a mother. You will always have a mother”, said the life coach in me. Immediately, some of the sorrow left his eyes, the droop of his shoulders straightened. “You’re right”, he said. “I will always have a mother.” 

The idea that his mother’s death negated her existence in his life had caused further suffering. Unnecessary suffering. There is the pain of the loss of a physical person in his life. Then there was the additional pain created by erasing her existence. It was unnecessary, this additional suffering because she did exist. She exists still in his memories of her. The reality of her life lives on in his life, his breath, his siblings, and his children. 

As we grieve, it’s important to separate the grief from the event itself from what you tell yourself about it. The suffering that arises in response to the event can be considered “clean pain”. It just hurts to experience a loss. 

Initially described by Steven Hayes, PhD, clean pain is the natural response to loss. It is pain that is inherent and cannot be entirely avoided. Whereas, “dirty pain” is created by your thoughts, the things you tell yourself about the loss. When my friend lost his mother, his clean pain was from her death. His dirty pain was from the thought “I don’t have a mother anymore”, forcing him to release even the memory of her. Clean pain is inevitable in the human experience. Dirty pain causes optional suffering.

I wondered, at the time, how I would experience the death of one of my own parents. It is such a right of passage, this particular grief that occurs with much less frequency than the other sorrows in our lives because it is such a singular experience. 

And this year I went through the death of my father. We hadn’t been close in years. He had stopped being the dad of my childhood so long ago that I discovered I had already grieved him, or the loss of him, and come to terms with the residual relationship we had, limited though it was. It is still strange to think that I will never speak with him again, although I have three or 4 years of birthday greetings saved in voicemail. Residual imprints of his life and our relationship. But I don’t consider it “not having a father anymore”. 

Then three months later, after a long period of anticipatory grief, I lost my canine companion in April. She was much more of an integral part of my daily life than my dad, although like my dad she suffered a gradual decline to the point of death being a release from the trappings of a body that no longer served her as it once had. 

For months before it happened, I mourned her eventual death. And her death, when the sorrowful day came, was not nearly as devastating as I expected. Perhaps I’m still dodging the feelings of grief that could lie in wait when I round a corner and see the empty space where one of her many dog beds used to be. It does still hit hard sometimes, but other times, it just is. It’s just life and its eventual end. The reality is that impermanence comes for us all. 

I find I still speak of her in the present, as if she’s still here, because her memory is still so fresh and present, but the loss is accepted for what it is. No more. And no less.

I don’t tell myself the story of how awful it is, perhaps because it was so clearly time, for both her and my dad. I’m sure the shock of sudden death would be so much harder to bear. All the “what-ifs” and “if-only” that the mind can create. I imagine that’s more like a tsunami than the waves, some gentle, some not, that I have experienced.

Grief is also a very individual and unique experience. There aren’t correct steps to it. There is no right time to do it in. I’ve had some clients experience shame because “they weren’t grieving right”. Their experience of grief was deemed too long or too short, too shallow or too deep by someone else. Or even their internal voice. The is no one right way to do it. There is only acknowledging the loss when it arises within you and allowing it to release through you. It may be one of the least linear encounters you have in this lifetime. 

My advice for those experiencing grief:  Invite it in. It’s right here anyway. Don't resist it. Allow it to have its season in your life.  Grief is the necessary pain of love and loss. You cannot outrun or escape it. Don’t hurry through it, as unprocessed, it’ll just hang around longer. You also don’t have to park yourself on grief’s sofa for an extended period of time.

But be on the lookout for sneaky dirty pain, the uninvited guest who says, “It shouldn’t have happened”. “It should be different.” The thoughts that want to insist that a different ending was possible and better. They will haunt you but they don’t actually help you in any way. It just piles anguish onto the grief.

Let grief have its way with you. At first, it’ll crash over you, pounding you to the shore with its strength and overwhelming power.  But over time the waves will grow smaller and less intense (at least that has been my personal experience–your mileage may vary.) Once you’ve been drenched by all the grief and then dried out, the love and memories remain to be treasured in their sweetness, like ocean waves that gently wet your feet and ankles in greeting.

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