I recently worked with someone who had his heart crushed by an individual who led him on for months, asked for his help with various tasks, accepted an invitation to go on an official date, and then ultimately, on the “date,” said she doesn’t date.

Knowing the timeline and details, I had been confident this relationship was headed in a positive direction and wound up feeling disappointed at how it had crumbled to pieces, leaving us both stunned and confused. This happened to somebody who has done so much work in terms of gaining self-confidence and developing interpersonal relationship skills. Having an important relationship dissolve in an instant was devastating.

We processed the experience and the many questions that arose in our next session: Where did he go wrong? Why did she agree to the date in the first place? Did she not date in general or did she just not want to date him? Did her rejection not confirm his feelings of unworthiness?

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As much as we could speculate, analyze the chain of text messages, and try to make sense of what transpired in the relationship, the frustrating truth was there was no logical justification for what happened or why this person treated him the way she did. At least not one he was ever going to be privy to.

He reached out for some clarification, but her responses were arrogant, passive-aggressive, defensive, and left no explanation for how he could have possibly misread her signals. Further, they changed his view of who she was and left it nearly impossible to continue their friendship. He grieved the loss, missing the person he thought she was.

We spent a good amount of time discussing what he should do next. He wanted answers that made sense, but instead he was being ignored. A part of him wanted to contact her, lashing out with his anger, to let her know exactly what he now thought of her. A part of me wanted to support him in doing that. I was appalled by her callousness. I was angry for him.

He wanted closure. At the same time, we both knew it likely wouldn’t accomplish anything. She wouldn’t change, her responses wouldn’t become any more enlightening or helpful, and there was probably no realistic scenario that would lessen his hurt.

The knowledge you were the better or stronger person, or you were mature enough not to burn a bridge, doesn’t feel like much of a win amid the pain and anger. But resisting the temptation to lash out or search for answers you may never get forces you to face the pain head-on.

When this kind of thing happens—when a relationship ends in hurt and anger, when we feel like the rug has been pulled out from under us, or when life doesn’t go the way we were hoping—we want an immediate sense of closure or justification. The desire for closure might be the temporary satisfaction of telling off the person who hurt us, gaining an apology, having the person change their mind, or getting some type of definitive ending that seems clean and makes sense to us.

But the reality is these things generally don’t make us feel better in the long run. Typically, they simply never happen. So the search for closure is often futile and results in wasted energy, more frustration, and a delayed ability to begin healing and moving on.

It takes a lot of strength to be the “bigger person,” to walk away with your head held high, and to resist the urge to give someone who has hurt you a piece of your mind.

The knowledge you were the better or stronger person, that you were mature enough not to burn a bridge, doesn’t feel like much of a win amid the pain and anger. But resisting the temptation to lash out or search for answers you may never get forces you to face the pain head-on. While highly uncomfortable, the sooner you acknowledge and accept the disappointment and hurt, the sooner you can begin to move forward. It may involve coming to terms with the fact sometimes things aren’t logical or fair.

Having the strength to walk away from a negative experience with a sense of grace and your dignity intact will likely help you to feel good about yourself in the long run. With time and some distance, you may discover the experience taught you a valuable lesson or helped you grow in a way only the most challenging of experiences could.

From the time children are born, they count on their parents to provide a sense of safety as they learn about the complex world around them. When a parent dies, it may create intense emotional upheaval for children old enough to understand what has happened. Often, children do not know what to do with those feelings. Surviving parents, guardians, and other adults have a difficult task in helping such children process their grief and move forward.

Perhaps the most important thing anyone can offer a child who has lost a parent is time. Grief does not happen on a specific timetable, and the process of grieving may look very different from one child to the next.

In addition, adults can encourage children to share their feelings safely and without judgment. It is helpful to refrain from using words such as “should” or “should not” when talking to children about a loss or trauma they experienced. Adults can also facilitate a sense of togetherness or shared struggle to ensure children do not feel alone in their grief, and encourage compassion and support among other kids or people in the child’s life.

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The specific challenges facing children who have lost a parent include:

• Accepting the significance of the loss (it changes them forever)
• Allowing the grief process to unfold on their own terms as they work through painful feelings
• Transitioning into an environment where the parent is no longer physically present
• Maintaining a sense of connection with the lost parent while allowing themselves to live their life

Surviving parents have the unique challenge of providing support for their children as well as processing their own grief. Some parents may feel inclined to grieve in private, believing it is in the children’s best interests to shield them from displays of pain. However, it is appropriate and healthy to allow children to see adults grieving because it signals that is okay to feel the impact of the loss and to openly express their own grief. The objective is to help children understand they are loved, supported, and far from alone in the grieving process.

Often one of the biggest challenges children face when they lose a parent is to accept that they may be experiencing many different feelings. This is normal, and it’s important for children to know that. It can be confusing when they feel emotions such as anger and yet miss their parent at the same time. Children may believe it’s better not to show emotion and that if they don’t, they may be able to forget about the parent they lost or forget the pain they feel. Caring adults need to let children know that when someone they love dies, it’s important to remember them and cherish the positive memories they have.

It’s important to help children understand that the goal is not to “get over” what happened, but to move toward acceptance. They will never get over it; the loss of a parent changes a child from that point on.

It’s important to help children understand that the goal is not to “get over” what happened, but to move toward acceptance. They will never get over it; the loss of a parent changes a child from that point on.

Adults often find it difficult to know what to say to children who have lost a parent. Others may be wary of bringing up difficult feelings in children or reopening emotional wounds. As a result, the topic may be avoided altogether, creating an “elephant in the room” effect and contributing to feelings of isolation.

The primary goals for caring adults in the lives of children who have lost a parent are to encourage them to accept their feelings rather than push them away and to offer support whenever it is needed. Often during the grief process, children will move back and forth through the various stages of grief. Being available to listen whenever they’re ready to talk may be what is most comforting to them.

Ultimately, children need to know that there is no “right way” to get through the grief process. Everyone experiences it differently, and children should be encouraged not to judge themselves if the way they experience their grief is different from the way someone else does.

“In the beginner’s mind there are many possibilities, but in the expert’s there are few.” ―Shunryu Suzuki

To view life with a beginner’s mind is to look at the world through the eyes of a child. The world becomes a place that is full of curiosity and wonder. I’ve witnessed this when I watch children at play. Sometimes they are amazed, open, and playful, but at other times they may be sad, restless and cranky. Yet no matter their mood, there is almost always a willingness to start anew: they are open to the next experience.

In contrast, we as adults can be guarded and cautious with our feelings. We tend to turn away from pain, and when joy arises, we want to cling to it. This conditional way of approaching life can have a negative impact on our emotional well-being, as it tends to create a limited sense of self and a narrow view of the world.

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Look at the world through a child’s eyes.

Sit with a young child for even a few moments and your perspective on life can shift. Children look at the world with eyes of interest and fascination, drawing joy from the experience of playing in the snow or simply watching leaves being blown by the wind. They also readily feel and express all emotions. Children cry when sad, laugh when happy, express anger when disappointed or scared, and play when the opportunity presents itself. In short, they experience life fully, with few expectations or judgments about how things should or shouldn’t be.

When we put away childish things, we lose our innocence and wonder.

“We don’t have to create joy. It’s an innate quality that at times is hidden or dormant. As innocent babies we all have a natural joy. When we’re not overwhelmed by stress and suffering this natural state becomes revealed.” —James Baraz

As we move from adolescence into adulthood, we often lose our connection to our natural joy and openness, the sense of wonder we experienced as children. It’s as if somewhere along the passage to adulthood, we learned that being authentic and experiencing life fully was no longer acceptable.

When we lose our ability to be open to what’s happening, we often instead find ourselves trying to manage and control things, people, and experiences that are beyond our control. We no longer maintain a connection with the joy, vibrancy, and realness contained in every moment of life but connect instead with our thoughts about how life should be. This attempt to control is reactive and is often driven by our aversion to what is happening in our lives.

 Our ability to see life as a mixture of pain and joy allows us to experience life to its fullest extent. We learn to open to joy when it arrives, to take it in through our senses and appreciate it, with the knowledge it is a visitor that comes and goes.

By cutting off our vibrant connection to life and diving into the murky world of thoughts, judgments, anxiety, and worry, we lose access to what is healing, joyful and transformational. Sometimes, we can become stuck in this virtual world and lose sight of reality.

Coming back into balance with life.

“And could you keep your heart in wonder at the daily miracles of your life, your pain would not seem less wondrous than your joy.” —Kahlil Gibran

The truth is that life is not divided solely into sorrow and joy. Neither of these extremes reflects the reality of life. Together, they represent life as it is. Our ability to see life as a mixture of pain and joy allows us to experience life to its fullest extent. We learn to open to joy when it arrives, to take it in through our senses and appreciate it, with the knowledge that it is a visitor who comes and goes.

Eventually we learn to do the same with all other experiences and open ourselves to all feelings: sadness, anger, joy, happiness, and grief. We stay present in the face of pain and sorrow and respond with compassion and kindness. The power of the compassionate heart is such that it helps us stay open to painful experiences in ways that can heal and transform us. It is when we open ourselves to pain that we realize how precious life can be and that we don’t know when it will end. In doing so, we may learn how to better appreciate life, with all its joys and sorrows, instead of avoiding certain experiences.

Sometimes joy is felt when we are at our most vulnerable because that is when our hearts and mind are open to taking in life as it is. 

I’d like to share a personal example of a challenging and painful time I went through with my family.

In 1997, I waited with my son and family in the coronary care unit of the hospital where my father had been admitted. His prognosis was grim, and we had all come together to support each other and our mother. In possession of the painful knowledge that our father was dying, it was challenging to stay present, and we were all caught up in a state of worry, grief, and fear.

Eventually someone said something—I can’t tell you what was said—and what happened next took us all by surprise: My son, who was 4, laughed out loud.

I don’t know what he saw or heard that elicited such a joyful response, but that isn’t important. What is important is that the sound of his laughter was like a balm to our broken hearts. It wasn’t just my family who was affected by it. His laughter, like a ray of sunshine on a cloudy day, shifted the energy in the room. It didn’t make the sadness or the deep hurt of losing a loved one go away, but it helped us to see that there can still be joy, even in the midst of deep pain and sorrow. In that moment I could see that life is a truly a miracle, filled with both joys and sorrows.

I believe that to be present and open to experiencing all of these joys and sorrows truly is a blessing.

May you be well.

Dear GoodTherapy.org,

I recently attended my father’s funeral, which was a very large gathering with family, friends, and people in the community. He touched many lives and was well-known around town, so hundreds of people showed up to pay respects. Tears were shed, handshakes and hugs were exchanged, and memories were shared. It was an emotional day, to say the least … but I didn’t even come close to crying. In fact, I haven’t cried at all since he passed. I’ve tried, because it seems like the thing to do, and because people have been telling me things like, “You just have to let it out,” or, “You’ll feel so much better afterward.”

In general I don’t consider myself a very emotional person, though I’ve been known to shed a tear at sad movies. And I cried when my childhood dog died in my 20s. So it makes me feel even worse that I was able to express some emotion at those times and not now, at a clearly more impactful loss. And it’s not like I hated my dad, either. We’d grown apart in recent years, but I have positive memories from my childhood when my dad was around and not away for military service, as he often was.

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My two siblings are grieving in “normal” ways, and they definitely think I’m some kind of monster for not crying at all, especially at the funeral. Meanwhile, I’ve been the one with a clear head on my shoulders to help our mother arrange the memorial, get her finances in order, etc. So at least some good has come out of my apathy. But I do wonder why I’m not reacting more strongly, and whether I should be doing something to make myself move through grief more.

Would it be helpful to try to make myself cry? Does crying need to be a part of grief? I don’t want to draw the grief process out unnecessarily if I can instead just move forward. —Dried Up

Submit Your Own Question to a Therapist

Dear Dried Up,

A parent’s passing can be a momentous time in one’s life—and assuming we know and outlive them, we all experience it eventually. Each of us will react in our own way. That means we will cry or not, feel sad or not, feel free or not, feel glad or not. Whatever our feelings or, more accurately, mixture of our feelings, we will be affected—some people more, some less, some more openly expressive, some less. That’s all part of being human.

You dubbed yourself “Dried Up.” I was surprised when I read that. What does it mean? Then I thought, “dried up” implies that what was wet before is dry now. I wonder if there were times in your early life when you were unhappy, and now you’ve reached equilibrium.

You write that you cried when your dog died and you also cry at certain movies. Some movies are arranged to make people cry; that’s their purpose. And when your dog died, you were in your 20s, a time when people start truly becoming adults. Although I don’t know you well enough to unravel what made you who you are, it’s certainly possible your dog’s death may have been associated with the end of your childhood. If so, you may have cried both for the dog and also that it marked the ending of a precious time in your life.

Now that your father has died, you wonder why you don’t cry. You wonder if there is something wrong with you, perhaps. That presumes that crying is not only normal, but mandatory.

Who says you have to cry? Every person experiences grief in their own way and in their own time. Everybody expresses their emotions differently, and there is no right way to do it.

Who says you have to cry? Every person experiences grief in their own way and in their own time. Everybody expresses their emotions differently, and there is no right way to do it. It’s a purely individual matter. You write that you are generally reserved emotionally—that’s neither a positive nor a negative attribute, but rather a description of your place on a continuum of emotional expressiveness. Some people are more openly expressive, some less, just like some folks have brown eyes and others have blue eyes.

Your siblings seem to have precise ideas about the right and wrong ways to have feelings and subsequently show them. I wonder if this is not part of a larger story about how you relate to one another. They are not pleased with you because you did not display grief as they did. Do you all have to be the same? Is there only one way to be?

You speak of your apathy. I’m not sure I understand what you mean by that, and I wonder if you might mean impassivity rather than apathy, so I looked up apathy in the dictionary. Merriam-Webster differentiates apathy from impassivity: “Impassivity stresses the absence of any external sign of emotion in action or facial expression.” What’s wrong with that?

I definitely do not think you should make yourself cry. You shouldn’t make yourself do anything. Just be yourself and let things take their natural course.

Take care,

Lynn

I am so sorry for your loss. You are understandably grieving. You’ve lost your partner unexpectedly, and if that weren’t enough to cope with, you are also trying to take care of your grieving children—who are likely trying to make sense of an incomprehensible situation. Of course you are struggling.

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You get overwhelmed because your reserves of emotional energy are depleted. Having enough to give to three children is challenging in the best of circumstances. Finding ways to give under these circumstances requires superhuman strength. Additionally, if you are feeling bad about taking time for yourself, that “me time” people recommend isn’t replenishing you but rather adding guilty feelings to the mix. I’d be surprised if you weren’t struggling.

Feeling lost and disconnected and sad and angry are absolutely natural responses to all of this. Grief is complex.

You ask if you are afraid of losing your children or afraid they will bring painful memories of your husband. You also wonder if your anger is a factor. The answers are inside you, but based on what you’ve related, in all likelihood yes—to all of it, and probably more. Your world has changed swiftly and dramatically, and not by any choice of your own. Feeling lost and disconnected and sad and angry are absolutely natural responses to all of this. Grief is complex.

The stages of grief—denial, bargaining, anger, depression, and acceptance—do not necessarily flow smoothly or quickly. Many people move from one stage to another and back again as memories and feelings are triggered. There is no timeline for moving through your grief and integrating it. Time will help, but so will finding the right kind of support.

If you haven’t already started working with a therapist in your area, I recommend that you find one for yourself and for your children, either together or separately. Having a safe and supportive place to work through all the feelings that come with such a loss and major life transition can help you heal and find your way back to your children … and yourself.

Best of luck,
Erika

I am so sorry to hear about your situation, and cannot imagine the pain you and your wife must be experiencing as she fights her battle against cancer. Let’s get to the root of your questions.

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You love each other. You can’t help being what she needs you to be—she needs you to be you, loving her, and you clearly do. Yes, you will be optimistic if you can and if that helps. Yes, you can cry in front of her after she has had sufficient time to digest the news, and you can cry together to mourn the life that you will not have together, as well as to celebrate the life you have together now and have had to this point. You are grieving. Of course you are grieving. Please allow yourself to grieve in whatever way you need to. Although you say your wife is acclimating to the news better than you are, it’s possible she’s trying to stay “strong” for you, and is grieving inside every bit as much as you are. It’s OK to grieve together. In fact, it could be very helpful. Talk to your wife about what you are feeling and see how she feels about experiencing your grief as a team.

Four years may be a pittance of the time you wished you might have, but it’s also a treasure chest of breakfasts and dinners, fights and laughs, walks and longer journeys, complaints and compliments.

You describe your wife as a fighter, and you sound like you are one, too. You will find ways to be together and do the things you love best. And in those times when grieving in front of your wife doesn’t feel like the thing to do, when you need to scream and holler and let go, it’s absolutely OK to find a private place and do so. You can walk down a busy city street and yell your heart out (I’ve done this myself), or you can hide in the woods and do the same. You can lean on a good friend or family member who will help you mourn and be angry and be thankful, and break apart and heal and hold together.

You have time still to show your love, to enjoy the everyday-ness of being together. Four years may be a pittance of the time you wished you might have, but it’s also a treasure chest of breakfasts and dinners, fights and laughs, walks and longer journeys, complaints and compliments. You will be brave and cowardly, angry and loving, and express all the emotions that humans are capable of feeling, and you will do so both together and separately. All of it is OK. All of it is normal. All of it is whatever you make of it. Please let yourself feel what you feel.

Your wife needs help, yes, but don’t forget that you do, too. You need and deserve supportive people—family, friends, perhaps even groups who will help you through this. You can’t do it alone.

Many hospitals have support groups where people meet and help one another through difficult times. Are you members of a religious or spiritual group? Would you consider working privately with a therapist or counselor—someone just for you, or someone for you both? I highly recommend the empathic support of a therapist to help guide you through the range of emotions you’re feeling right now, especially a therapist who specializes in grief, loss, and bereavement.

I hope you can feel the love and peace that I wish you both.

Take care,
Lynn

Bereavement, the grief we feel in response to the death of a loved one, is part of our being in the world. It includes different categories of loss. There is the literal loss of the unique and irreplaceable other person. There is also the apparent loss of the functions that person carried in the relationship (he was the one who always filed our taxes; she was the one who held the family together). Here we can find as well the loss of the one who witnessed us (he was the last person who knew me when I was a teenager).

Less conscious is the—again, apparent—loss of self, of who one was in relationship to the loved one who passed.

Who among us wants to go through bereavement? Yet grief is a healthy response, and a necessary one in order to adjust and go on in a world where people die. At such times, our religious, spiritual, and philosophical beliefs can support us. It can also happen that such structures of belief or hope, which were previously unconscious, come forward spontaneously in response to loss. This can happen in the form of highly subjective, deeply personal experiences.

In the discussion that follows, names have been changed and personally identifying material has been screened out in order to preserve confidentiality.

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After the death of his partner, Jim finds himself waiting for him to come home, to hear the jingle of his keys in the door or to share a piece of news with him. Leah hears her husband call her name from the next room as she’s falling asleep at night. It’s not scary for her, but it brings her grief back when she starts to get up to attend him and remembers that he’s gone. Janet feels her husband sit down on the couch next to her when she’s watching television before going to bed. Annie, out on lunch break, has her eye caught by what appears to be a dear and departed colleague, waiting across the street at a bus stop. Mark sees a close friend twice after the friend’s death: once walking down the street “looking like hell,” the second time some months later, standing outside an Alcoholics Anonymous meeting. John rages at God each afternoon for the loss of his wife, and God—silent, invisible, but palpably present—hears him out.

These phenomena form a broad spectrum, from a subjective feeling to transitory perceptions when in a relaxed or distracted state. It’s important to note that none of these folks met the criteria for psychotic, mood, or substance dependence disorders at the time of their experiences. Bereavement, while not a formal diagnosis, can be a time of disruption, during which material that was previously unconscious comes into awareness. Often, the material serves an adaptive function. One way to support that adaptation is to treat it as symbolic rather than literal. As in dreamwork, we’ll look for what the experiences mean to the one having them rather than debating whether or not they “really” happened. When supported with empathy and respect, the events yield meaning and can be integrated into the person’s worldview, enriching it and making it more resilient.

Leah acted as caregiver for her husband in his final illness. As a result of hearing him speak her name, she reconsiders her situation. The role she filled for the last several years no longer has a purpose. The house where they raised a family and lived together is “too big” for her now. She begins thinking about moving into someplace smaller and closer to her adult daughter, so she can help out with her grandchildren. Annie notes that when she looked again “I saw it wasn’t Greg, not even someone who looked like him, really. But for that moment, I got to see him again. It’s like he paid me a visit.” When asked where Greg “was” when he visited, Annie gives a bittersweet smile and says, “In my thoughts.” Both Leah and Annie assimilate their experiences easily.

As in dreamwork, we’ll look for what the experiences mean to the one having them rather than debating whether or not they “really” happened. When supported with empathy and respect, the events yield meaning and can be integrated into the person’s worldview, enriching it and making it more resilient.

Like Annie, Mark sees a dead friend. Richard died of an accidental overdose, and Mark grieves as much for what seems to him the waste of his friend’s life as for his actual death. His two glimpses seem to be sequential and almost tell a story. In the first, Richard looks to be doing badly. Mark’s associations are that he has continued on the downward spiral he was in at the time of his death. The second glimpse, some months later, is of Richard among a group of others apparently taking a break outside an AA meeting place and looking “better than I remember seeing him for a long time.”

Mark doesn’t subscribe to the idea of life after death. But he was raised as a Roman Catholic in a small New England town. He notices that these experiences seem to refer to the idea of purgatory, a place or state where corrective balance takes place. Or as Mark puts it, with some humor, “It’s like Richard had to go to summer school so he could graduate.” Then he adds, “It makes me feel hopeful. I don’t want to make a religion of this, but it’s like the message is it’s never too late to get your act together.” The psyche provides Mark with images that help express and heal his grief.

Like Mark, John is surprised at his experience. He describes himself as “a scientific humanist, like Carl Sagan.” His wife’s death from cancer was drawn out and marked by suffering, both from the disease progress and from the treatment. John suffered with her. In this second month following her death, he tells me that he “indicts God” on his afternoon walks, giving vent to anger and bitterness that “someone who never hurt anyone suffered so much for no reason.” Angie wasn’t just his wife, she was his primary companion, and her loss makes the world an empty place for John.

The image of God, never previously active, becomes so in this crisis. It functions like a container for what might otherwise be overwhelming feelings, which John is then more safely able to identify and express in the form of his “indictments.” And more than an image: somewhat like Janet feeling her husband sit down next to her, John describes feeling God’s presence as an almost bodily sensation. Whether or not he goes on to live a religious life, in this period this experience provides a supportive and adaptive function.

As we see, some of these experiences are perceptual—auditory, visual, sensate. As a therapist, when someone describes such things, I look for some awareness on his or her part that these experiences are unusual. Also, that what’s experienced is characterized by feelings of grief or loss, or conversely by feelings of relief or hope. If the material is held concretely or literally, I would expect to find some cultural support for that. For instance, Kenny, a practitioner of Santeria, tells me that his recently deceased brother has given him some important information during a shell reading, or divination ceremony. Mary, first-generation Italian American, covers the mirrors with cloth so she won’t see her husband and “get taken by him.” Where I might become concerned is when there’s no such cultural cuing, or when the material is characterized primarily by feelings of guilt or worthlessness.

Alice tells me that she’s very distressed over the loss of her mother two years ago. She can hear the voices of the dead, blaming her not only for her mother’s death but for theirs as well. In order to get some relief from the voices, she accesses alcohol on a daily basis. She becomes distraught as she tells me this, weeping hopelessly. I don’t argue the matter with her, nor do I help her open it up for meaning. I tell her that I believe that she’s hearing the dead and it must be very rough. I ask if she’ll sign a release so we can call her doctor together and see if there’s something that might work better than alcohol.

Not everyone experiences these types of phenomena. For many of us, bereavement can be tracked through dreams. David, unable to be present when his father died, describes a dream a few months later in which his father enters the room David is in. After making eye contact with David (“so I could feel that he was at peace”), the father smiles, closes his eyes, and slowly leans back until David is left looking at the soles of his feet. Barbara dreams of her husband several times in the year following his death due to cancer. The dreams seem to form a sequence, in which she observes that her husband recovers from the symptoms of Alzheimer’s that were increasingly present the last three years of his life. “He looks like his old self now,” she says.

This phenomenon, the healing of the deceased in dreams, can generate different meanings. For Ron, his father wanted to come back and show him that he was all right. Bridget experienced this as a promise that our sufferings and their impact on us are reversible, and that there’s mercy operating in the universe. One additional meaning we might consider is that the healing of the image of the loved one corresponds to the healing and adjustment of the dreamer to the fact of loss.

We derive our personal meanings from the common experiences of loss. I expect you to come home because there are corners of the psyche where news of your death hasn’t reached yet. I hear your voice because I’m shocked by the sudden silence. I see you because I’m looking for you, and my eye assembles your lovely face out of whatever the environment provides—a stranger waiting for a bus, or someone smoking outside of a meeting place.

Although we know one another, much of our knowing is activity in our brains. The familiar face is conveyed by light that enters the eye and causes impulses to travel along the optic nerves and stimulate processing in the visual cortex, whose patterns of response are rendered semi-stable in the temporal lobe. Likewise, the voice. And likewise, too, our feeling responses and memories of shared events. The image we form corresponds to the other person, is alive, but is “made” of our own processes. When someone dies, it seems to be essential to successful adaptation to acknowledge and adjust to that fact. And after that adjustment, many of us find that in some very real ways, the image of the other person continues to live in us.

In psychotherapy, the first time a person tells me she dreamed of me, or that when facing conflict he imagined what I would tell him, I smile and say, “Now you have my image, and it belongs to you.” Later on, when working through closure and termination, we return to this idea. Bereavement is about ending. It’s also about ending’s opposite, which is continuation.

It’s the big question women and men who experience infertility or secondary infertility (infertility after the loss of a baby through miscarriage or stillbirth) ask: “I can’t have kids, so now what?”

Common questions and fears people have when they learn they can’t have kids include:

I always expected to have children and all my life plans included them. What do I do now?

Who am I if I don’t get to be a parent?

Who am I if I don’t get to raise a living child?

How do I live a fulfilled, happy life when the one I had planned was taken away from me?

Learning you can’t have kids, either for medical reasons or because you just aren’t willing to risk the death of another baby, can create a crisis of identity in even the most balanced and self-assured people.

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So when your plans for life drop out from under your feet and you lose your sense of self, what do you do?

Allow Yourself to Grieve

First and foremost, you need to grieve. Allow yourself to grieve for all the various aspects of this loss. Grieve for:

• The children you always dreamed of raising and will never know.
• The life you had always planned to live.
• The mother or father you expected to be.
• The loss of the certainty and innocence of life.

When children are strongly desired and you learn you can’t have them, it is a deep and profound loss. It requires the process of grieving every bit as much as the death of a loved one does.

Remind Yourself Healing Is a Process, Not an Event

The loss of the dream to have children is big. It leaves an emptiness that feels enormous and endless. Pretending that feeling of emptiness isn’t there would be counterproductive. Lying to oneself never helps matters. Trying to fill that massive expanse in your life left by the children you will never know can feel daunting and overwhelming.

When children are strongly desired and you learn you can’t have them, it is a deep and profound loss. It requires the process of grieving every bit as much as the death of a loved one does.

Be gentle with yourself and don’t pressure yourself to fill that gap immediately. As counterintuitive as it seems, befriend that empty space in your heart. Feel into the spaciousness and find the edges of it. Explore what that loss and emptiness feels like in your body.

This empty feeling is not your enemy. It’s a natural response to this deep and profound loss. This emptiness is a necessary part of healing.

Healing from this loss and creating a life that feels fulfilling and happy won’t happen overnight. It may take years of work and intention. It will be a process of grieving and redefining your life and creating a new identity, but it can and will slowly start to lighten over time.

Find Comfort in the Little Things

True healing is an intentional process. You have to choose to want to heal and take steps toward that. Seek comfort and healing in the little things in life.

Consider starting a gratitude jar and writing down one thing each day that you are grateful for. These don’t have to be big or insightful things; they can be as simple as being grateful for your coffee in the morning or the sunshine on your face.

Allow yourself to notice and appreciate the things about your life that perhaps you wouldn’t be able to enjoy if you had been able to have children. This doesn’t dismiss your longing or love for your children who died or never were. As humans, we are powerful beings, and we have space to both miss what could have been and be appreciative for what is.

Buy yourself flowers.

Sip and enjoy a good cup of coffee or hot cocoa.

Go for a walk in the woods.

Watch your favorite movie or read your favorite book.

Engage in activities that bring even a small amount of light and beauty into your life.

Give Yourself the Gift of Support

If you are fortunate enough to have family or friends who “get” this kind of loss and can be supportive, lean on them. Allow them to be there for you and to love you.

Seek out support groups, women’s groups, or men’s groups to surround yourself with others who can support and encourage you on your journey.

Find a counselor or mentor who will help you walk this rocky, painful path of recreating your sense of self and expectation for life.

Sometimes, finding the right support takes work. You deserve, however, to be supported and loved as you grieve.

Making Meaning Out of Your Life

It’s not about finding a reason why this may have happened. The cliché “there’s a reason for everything” isn’t really all that helpful to many people.

However, choosing to make meaning out of the events of our lives is empowering and healing. Decide what you want to make this loss mean in your life. Decide how you want to use it to create a new life going forward.

Life isn’t what you expected it to be. You may not get to be the person you wanted and planned to be. Choose to make this unexpected and unplanned life meaningful and fulfilling anyway.

You can’t bear children. That is painful and heartbreaking, but it is still possible to live a meaningful, fulfilling, and happy life.

In my practice, I see many mothers who have lost their only children during pregnancy or early infancy. They show up at my office struggling with grief and feelings of isolation. Some also grapple with infertility and the prospect of never being a mother to a living child.

Many of these mothers have been to multiple therapists or support groups, yet their search for adequate support continues. They report feeling like outsiders in support groups where other women talk about their living children or who are pregnant again after experiencing a loss. They talk about struggling to find a therapist who understands the unique experience of being a mother without living children.

Again and again, these mothers share feelings of invisibility and isolation and the intense grief of having empty arms with no children to fill them. More than anything, they want someone to acknowledge the pain of their loss.

Having an awareness of the unique experience of being a mother without living children is vital in supporting these women. Here are some things therapists should consider when supporting a mother without living children.

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There Is No Guarantee of a ‘Rainbow Baby’

It’s common in the world of pregnancy loss to hear talk about “rainbow babies” (babies born after loss). Often there’s an assumption that moms who have experienced loss will go on to have such babies. Many support groups include discussion of mothers desperately trying to get pregnant again.

I call the idea that another baby will fix a woman’s grief the “myth of the rainbow fix.” Even if a mother goes on to have a living child, it won’t replace the baby she lost or miraculously cure her grief.

More importantly, not all moms who have experienced loss have the option to have another child. Many moms are dealing with the knowledge that they physically or emotionally can’t have another baby. Others tried for years and are struggling with infertility. For many, the baby they lost was a “miracle baby” after years of apparent infertility and trying. Some have accepted that they may never have another pregnancy and have been on adoption waiting lists for years.

Not every mother who loses her child to stillbirth or miscarriage will have another child. Making the assumption that they can or will may be detrimental to the emotional health of these mothers.

Many Need Reassurance That They Are Indeed Mothers

Many mothers who have lost their only baby struggle with whether they are “allowed” to claim the title of mother. Their idea of what it means to be a mother has been suddenly and unexpectedly altered. Being able to claim the identity of mother even though their baby did not survive can be a valuable piece of the healing process.

It’s important to work with these women to redefine what “mother” and “mothering” means to them now that their baby is no longer physically here. In what tangible and intangible ways can they continue to mother their child?

Early Loss Does Not Mean a Lesser Loss

Far too often when a mother loses a baby early in pregnancy or has an ectopic pregnancy, her loss experience is minimized. Many women whose babies died in their first trimesters often feel that their grief is dismissed or invalidated through statements like, “It was so early,” “You didn’t really know it yet,” or, “You just found out you were pregnant, so try not to get too down.”

However, for many women the love and attachment come the moment they know they are pregnant. For others, the attachment and love were formed long before the pregnancy occurred, through years of trying to get pregnant, fertility treatments, or planning to become a mother.

Depth of love has no basis in time.

Questions about Children May Be Difficult to Answer

Many intake assessments and initial sessions for any kind of medical or mental health provider include the question, “Do you have any children?” or “How many children do you have?” For those who haven’t lost a child, this probably seems like a simple and straightforward question. For those who have lost one or more children, it’s often not so simple. Internal debate immediately comes up:

Do I say yes and explain?

Do I say yes, but then what if they ask how old he/she is?

Do I have the energy to go through the story all over again?

Maybe I should just say no, but I always feel so guilty when I do that.

What is his/her reaction going to be if I say I have a child but he/she is dead?

I want to acknowledge my child, but I don’t want to deal with discomfort and that awkward silence.

Gah, I hate this question!

For therapists, I don’t know that there is a good solution for the pain and uncertainty questions like this bring up. However, asking about living children and deceased children separately may make the situation more comfortable for mothers and help them feel more accepted.

Nothing therapists can say or do will completely take away the grief and pain a woman feels after the death of a baby. We can’t fix the ache of not having a living child to hold, raise, and love. As professionals and compassionate human beings, however, we can be more aware and sensitive to the unique experience of being a mother without a living child. Support without judgment or assumptions can go a long way toward healing, not just for these mothers but for anyone in pain.

“Go into your grief, for there your soul will grow.” —Carl Jung

Grieving is a powerful and personal journey. It is an inevitable part of living. Eventually we all grieve something or someone. If you’ve lost a child or parent, or a friend, lover, or spouse, you know that grief has the power to transform.

We usually live within the illusion that we are in control. That is, we live a certain way until something happens to shatter our perception. The resulting dissolution—or you might say dis-illusion—that follows is actually the beginning of a remarkable process of being healed. It marks the first stage in the grief journey.

Stages of Grief

In 1969, Elisabeth Kübler-Ross, a Swiss American psychiatrist, introduced the “five stages of grief.” Her work with people who had terminal cancer led her to define the five distinct phases a dying person goes through while coming to terms with their fate:

• Denial: Disbelief, shock, and numbness after hearing the “bad” news.
• Anger: When the numbness lifts, anger may be easier to feel than the intense pain associated with what is being lost. This free-flowing anger can be directed inward toward the self or outward toward doctors, nurses, friends, family, spiritual advisors, and/or God.
• Bargaining: For some, bargaining can be a reaction to the vulnerability that occurs when feeling the sorrow of loss. It can be an attempt to feel more in control of a situation where control just isn’t possible. It is characterized by an attempt to seek the impossible; to find a way out.
• Depression: The full impact of the unmasked impending loss of life finally hits, and feelings of sorrow, sadness, and depression follow.
• Acceptance: Coming to terms with what is happening and finding a way forward.

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While many have applied these stages to the process of grieving the death of another person, it was not Kübler-Ross’ intention that they be used this way when she created the model. There are other models that are more specific to grieving the loss of a loved one that are used by grief counselors and therapists. While the stages described by these models differ somewhat, like Kübler-Ross’ model they all chronicle a journey-type process that leads to acceptance and the eventual ability to once again move forward.

Acknowledging Brokenness; Being Present

When the shock of sudden loss subsides, the numbness that initially accompanies that shock wears off as well. A pain-filled state ensues when the harsh reality of loss is realized. This early phase of grief is about brokenness. When we experience a loss, the bond that once attached us to the other—whether the other is a person, place, or thing—is severed. When the bond that ties is severed, we feel as though we have been broken. It is a painful and searing state; a state that can’t be rushed.

What a grieving person in this stage needs most is to feel that those they are closest to can accept the pain they are experiencing. Unfortunately, many people are uncomfortable with their thoughts and ideas about endings and death. The feelings that arise with grief are just too much for them. Their attempts, aimed at getting a grieving person to feel better and leave the sorrow behind, only serve to prolong the grief process.

A kind touch and a shared quiet moment that honors the feelings of a grief-stricken friend can be the best offering of condolence. A willingness to simply be present, to witness and accept the raw emotions of grief, is the first step in a transformative and healing process for both the bereaved and those who surround them.

Support Groups

The feelings that come with grief are powerful. Grieving takes time, and often the family and friends of a grief-stricken person are ready to move on long before the grieving one can or wants to. Support groups are a viable option for those who find themselves alone in their grief. Being able to share the experience with others on the same path may be a relief. Since the grieving process is different for everyone, a support group can accommodate these differences. Some studies suggest that men and women grieve differently, with women needing to speak about and share their intense feelings with others while men often deal with their own intense emotions by taking action. In a support group setting, all experiences can be heard, shared, and validated.

Widows and widowers in the gay community often have difficulty finding the support needed while experiencing the grief of bereavement. Even finding a support group can be difficult. Blogger Dan Cano writes poignantly about his experience after finally finding a support group where he could speak freely and be understood:

“I started my lesbian and gay bereavement group a few weeks ago, and every Thursday night we gather to tell our stories. We share of our history with our partners, lovers, husbands and wives. We share the trauma of losing the most central person in our lives. We tell of our difficult goodbyes, and of the daily anguish that we must now endure. We talk about being left behind, of feeling lost, of struggling with a new identity. We talk of people’s well intended, but missing the mark, words. We cry, we laugh, we listen.”

What We Learn from Grief

When we sit in stillness and accept the waves of grief that wash over, eventually there will come a time when the urge to move will stir. It will be quiet, unassuming, and almost imperceptible. From intense feelings over what has been lost there will arise a feeling of gratitude for what is remaining. When experiencing the loss of a loved one, an inevitable gratitude for life and living unfolds. The gift of grief is ultimately a strengthening of the ability to truly appreciate and value the process of being alive.

References:

1. Greenspan, Miriam. Healing Though the Dark Emotions: The Wisdom of Grief, Fear & Despair. Shambhala Publications Inc. Boston, Massachusetts, 2003.
2. Hanson, Rick, Ph.D. (2007). Grief Recovery: Implication of Neuroscience and Contemplative Wisdom. Retrieved from: http://www.wisebrain.org/KaraSlides.pdf on 21/06/2014.
3. Cano, Daniel (2009). Gay Grief. Retrieved from http://daninrealtime.blogspot.ca/2009/11/gay-grief.html on 22/06/2014.