Healing Grief through Compassion and Love

Frank Ostaseski was recently interviewed during the 2020 Mindfulness & Compassion Global Summit by Rheanna Hoffmann on the topic, Grief and the Healing Power of Love and Compassion.  With so many deaths worldwide from the Coronavirus (410,000 at the time of writing), the issue of grief and its manifestations becomes increasingly prevalent.   Frank is the cofounder of the Zen Hospice Project (now called The Zen Caregiving Project) and founder of the Metta Institute designed to provide creative education in the art of “mindful and compassionate end-of-life care”.

Healthcare professionals may not have lost loved ones through the virus, but they can experience grief too with the loss of patients that they have been caring for – this is in addition to other stressors that challenge their resilience.  In his interview responses, Frank explained the nature of grief and the power of compassion and love to heal people who have experienced profound grief.

The nature of grief

Frank who has supported more than 1,000 people in the process of dying maintains that grief is not a single point but a process – an evolving process of “loss, losing and loosening”.  There is the initial shock of the loss that can result in physical collapse and total disorientation.  Shock impacts people differentially – some people may experience numbness, there is no “one way”.   Beyond the initial shock of the loss, is a process of “losing”, where in the midst of other things an overwhelming sense of loss returns accompanied by strong emotional and physical symptoms.  “Losing” can persist for many years and eventually become an intermittent event.  In the meantime, the process of “loosening” commences with progressive release of the hold that grief has over a person.

People grieve in different ways – some withdraw and have a strong desire to be alone with their grief, others experience tears and crying uncontrollably, while still others may take out their grief by aggression and violence (such as is occurring in the riots in America in relation to the Black Lives Matter movement).  Grief and our response may be aggravated in challenging times such as the pandemic where everyone is experiencing a form of “emotional inflammation”.

Frank maintains that grief has many faces, e.g. anger, rage, sadness, depression, fear and even regret.  He also suggests that grief results not just from the sense of loss of a loved one but also from the associated lost opportunities – a young life cut off in their prime, a missed opportunity to reconcile with a loved one, a lost chance to say goodbye or to be physically present with someone as they were dying.   For people exposed to dying and death as a result of the Coronavirus, there can be a collective grief brought on by the lost opportunity to save lives, as well as the lost opportunity of the lives lost.

Healing grief through love and compassion

The starting point for being able to show compassion towards the people experiencing grief is having an understanding of the nature of grief and its many forms of expression. It is important not to add to the stress of people who are grieving by communicating expectations of how their grief should be expressed.  Grieving is a very personal process and requires compassionate attending and listening, not the projection of personal preference.

Pema Chödrön discusses ”compassionate abiding” in our own grief and suffering as the pathway to expressing compassion for others.  Frank suggests that we need to “metabolize” our own fear and suffering by facing it fully, experiencing it in our body, mind and heart and converting it to compassion for others.  He maintains that when we can explore our own experience through self-observation and self-inquiry we can “build an empathetic bridge to other people’s experience”.  Otherwise we can be working out of our own distress and needs rather than the needs of others who are grieving.  Without this level of self-intimacy we can appear dishonest or disingenuous to others we are trying to help in their grief.

Frank explained that he has difficulty expressing self-compassion but has developed a number of processes that enable him to express compassion for others.  Each night before going to sleep, he focuses on the suffering of others – those who might be suffering through loneliness, those experiencing grief or those who are caring for others who are dying.  Through this process he feels love and warmth towards others and the emergence of his “innate compassion” that is broad and deep enough to absorb or dissolve his own experience of suffering.   In the morning, with his hand on his heart, he asks himself, “What would love have me do today?”

Reflection

Self-intimacy is a key to genuine compassion towards others who are grieving.  Compassion and love help to heal grief because they involve abiding fully with someone who is experiencing grief, not trying to fix them.  Our very presence, uncontaminated by unrealistic expectations of the other person, can be a source of healing just as “listening generously” can be.   As we grow in mindfulness, we can develop self-intimacy, calmness and peace and be better able to be present to and compassionate towards others.

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Image by Gordon Johnson from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Self-Care for Healthcare Professionals

Dr. Reena Kotecha presented at the 2020 Mindfulness & Compassion Global Summit on the topic of self-care for healthcare professionals.  Reena highlighted the irony of healthcare professionals caring for everyone but themselves and, in the process, suffering pain, disillusionment and burnout.  She shared her own story of depression, mental illness and suicidal thoughts resulting from working as a young doctor in an emergency department in a hospital.  She was drowning in self-doubt, suffering anxiety about the future and trying to cope with her present level of stress symptoms such as palpitations and sleeplessness.  Reena found her way out of the dark hole of depression through meditation.

She highlighted the stresses that healthcare professionals are experiencing in these challenging times of the Coronavirus.  Reena spoke of frontline healthcare workers who had to move out of home to protect their family and/or elderly parents, of the sadness and grief they experienced with the death of patients, of the frustration of having inadequate resources (such as personal protective equipment) and of their fear for their own safety in terms of the impact of their work on their mental and physical health.  Frontline professionals experience the intensity and immediacy of Coronavirus-related stress and emotional inflammation as a result of the risks to the life of their patients and their own life.

Barriers to healthcare professionals seeking help

Reena emphasised that healthcare professionals not only tended to overlook caring for themselves but also failed to seek help for their mental welfare when they really needed it.  She spoke of the barriers that stop healthcare workers from seeking professional support (some of which she experienced herself):

  • Training focus – all the focus of their training is on how to care for others, very little of the training is focused on caring for themselves or how to seek professional help for themselves
  • Priority focus – healthcare professionals are singularly focused on caring for others and they fail to give priority to their own mental and emotional health that would actually enable them to care for others more effectively and in a more sustainable way.  As Reena points out, healthcare professionals are much more comfortable and more proficient in the role of caregiver than that of “care-taker”.
  • Career focus – healthcare professionals become concerned about what others, including management, would think of them if they admitted to not coping and experiencing some form of mental illness (which still carries its own stigma).  They can be concerned about how others will judge them and what impact this would have on their career.
  • Expectations focus – the community has highlighted the heroic efforts of the frontline healthcare workers but this brings with it an unrealistic set of expectations that they are all strong and courageous, free from normal human emotions of fear, anxiety and self-doubts and the resultant experience of depression with its concomitant impacts of inertia, exhaustion, reticence and lack of energy.  In the light of this community expectation set, they are reluctant to admit to “weakness and fragility”.

Young healthcare professionals may begin their career with an unerring focus on their patients, giving priority to their caregiver role and ignoring their own needs.  They may feel really uncomfortable about being seen as “needy” or becoming a “care-taker”.  Professionalism is interpreted by them as being strong and efficient, able to cope with any situation.  Gradually, however, the singular focus on patients begins to take its toll and is compounded by the fact that no matter how hard or fast they work, demand continues to outpace resources and capacity.  They begin to experience stress, fatigue and sleeplessness.  Despite these signs of not coping they push on – driven by their own expectations and the perceived expectations of others, including the “worshipping” community.  Burnout results when the gap between what they are putting in and their intrinsic satisfaction with their work widens to the point where they lose belief in the value of what they are doing – burnout occurs on the physical, emotional and spiritual levels.

Mindfulness as self-care for healthcare professionals

Self-care for healthcare professionals is a lifetime passion for Reena, partly generated by her own early professional experience but also reinforced by the healthcare workers who seek her help and support during these highly stressful times.  She is the founder of Mindful Medics – an 8 week course for healthcare professionals incorporating mindfulness, emotional intelligence, neuroscience and positive psychology. Participants in the course have experienced significant benefits for their mental and physical health as well as in their overall personal and professional lives.

Reena is also a highly recognised public speaker on the topic of her lived experience.  For example she presented at the Happiness and Its Causes Conference in 2018 on the topic, Personal Story: Healthcare Starts with Self-Care.   In her Summit presentation, Reena provided a gratitude meditation designed to focus on appreciation for what we have in the present to displace a focus on a disturbing past or anticipatory anxiety about the future.  There is so much that we can be grateful for and savour in our life – nature and our environment, the development of our children, our achievements and rewards and the space of being alone

Reena in an article, titled I am grateful…, recommends strongly that we develop a constant practice of expressing gratitude for the simple things that we have in our lives and highlights the neuroscience research that supports the benefits of gratitude for mental health and wellbeing.

Reflection

It is important to express compassion for others, especially healthcare professionals and those directly impacted by the Coronavirus.  However, we have to recognise the enormous stress healthcare workers are experiencing in these challenging times and be more aware of not adding to that burden by perpetuating the expectation that they, individually and collectively, can cope with any challenge at no cost to themselves.  We can also offer our support for people like Reena who are helping healthcare professionals to develop mindfulness as a means of self-care.  The Mindful Healthcare Speaker Series is one ongoing event that we can support.

As we grow in mindfulness by focusing on self-care through mindfulness practices and gratitude meditation, we can become more conscious of what we are thinking and feeling and be better able to appreciate the present moment and all it has to offer in terms of overall wellness and happiness.  Mindfulness enables us to identify our barriers and expectations, acknowledge when we need help, develop strategies to cope more effectively and progressively build our resilience.

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Image by Petya Georgieva from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Overcome Your Habituated Way of Reacting and Restore Your Energy and Power

In her podcast interview with Tami Simon, Dr. Lise Van Susteren identified four patterns of reaction to life challenges that she describes as “survival strategies”.  If we can understand these patterns of behaviour, we can regulate our normal way of responding to stimuli we encounter in life and develop more tolerance towards others.  In her book on Emotional Inflammation, co-authored with Stacey Colino, Lise offers a process to discover our triggers and recapture our balance, energy and power.  The book spells out the 7-step process, called RESTORE, and looks at ways we can personalise this process in line with our preferred survival strategy.

Four survival strategies that become habitual behaviour patterns

Lise maintains that the four survival strategies she has identified are based on solid empirical evidence and her own life experience.  She suggests that your preferred survival strategy is shaped not only by your personality and temperament but also by your life experiences and the people who influenced you throughout your life.  The four survival strategies are:

  • Nervous – fearful and anxious because they are able to clearly see dangers, both present and pending, and are capable of providing a warning and catalyst for action through their vigilance and thorough research (they “run the numbers”).
  • Molten – angry and outraged response to situations that are perceived as immoral, unjust or irresponsible and that constitute grounds for justifiable anger.
  • Revved – frantic response to the needs of others leading to ignoring own needs and resultant personal exhaustion.
  • Retreating:  a reflective and considered response that exhibits humility and compassion for others while exercising patience in the pursuit of resolution of issues and challenges.

Lise identified herself as a person who adopts the “revved” survival strategy.  She cannot say “no” to requests and finds herself in a whirlwind of activity giving talks and presentations and writing articles and other publications.  She identified Greta Thunberg’s “How Dare You” speech to world leaders, participating in the 2019 UN Climate Action Summit, as an example of a “molten” survival strategy – her words and actions precipitating a global, youth climate change movement.  In reflecting on my own response to the Coronavirus and its resultant impacts, I can identify my survival strategy as “retreating” – which is clearly shaped by my life experiences and the people who were most influential in impacting my thoughts and actions in response to anxious and challenging times. 

Lise suggests that if you can understand your habituated survival strategy, you will not only be more tolerant of others but also be better able to respond differently and more effectively when the occasion demands it – because you will have been able to reduce your “emotional inflammation”. She proposes the RESTORE process as a way to achieve these ends.

The RESTORE process

Lise maintains that the RESTORE process is a pathway to overcoming habituated responses to the things that trigger us while providing us with a means to regain our equilibrium and power to contribute to a better world.  Each of the seven steps of the process draws its name from one of the letters of the word, “restore”:

  • Recognise your feelings – identify and name your feelings, not denying or avoiding them.  The more you deny your feelings, the stronger they become and the greater is their influence over your words and behaviour leading to an increasing number of negative, unintended consequences.  This also involves getting in touch with your body and what it is telling you about your level of stress and agitation and the difficult emotions you are experiencing, particularly in situations where you perceive you have no control over what is happening.
  • Examine your triggers – gain an understanding of your triggers and their impact on your words and actions.  This involves a willingness to reflect on situations that led to a high level of reactivity on your part.  It also entails identifying the people and experiences that have shaped your habituated, unhelpful responses.  The process previously described for dealing with resentment is an example of this self-exploration.   Both this step and the former require self-observation and self-intimacy that can be developed through meditation, mindfulness practices and reflection. 
  • Steady the natural rhythm of your bodybreathing with the earth, somatic meditation and mindfulness practices help to restore your equilibrium that arises when you are attuned to the natural rhythm of your body. 
  • Think yourself into a safe space – often we are overcome by negative self-talk which makes us inflexible and destroys our equilibrium.  Working with your mind is necessary to achieve emotional agility and the capacity to adapt to ever-increasing stress situations. Jon Kabat-Zinn provides a cautionary reminder that “you are not your thoughts” – they are like passing clouds, while you are the peaceful and resilient reality behind those clouds. 
  • Obey your body – this entails self-care including physical exercise, practices like Tai Chi and yoga, avoiding foods that your body experiences as harmful, reducing stress by achieving a better work-life balance and using self-care services especially if you are a carer.
  • Reconnect with nature – Lise suggests thatyou can “reclaim the gifts of nature” by accessing its healing benefits and its capacity to stimulate appreciation and gratitude and inspire awe.  Mike Coleman offers online courses on nature meditation to assist you to reconnect with nature.
  • Exercise your power – Lise argues that to consolidate your newfound equilibrium and power, you can become an “upstander” instead of a “bystander” – taking effective action in the world (e.g. on climate change) out of a sense of thoughtfulness, compassion, self-belief and hope.  This is the pathway to joy – pursuing a purpose beyond yourself that reduces self-absorption.

Reflection

As we grow in mindfulness through nature meditation, mindfulness practices and reflection, we can deepen our self-awareness and tolerance, build our understanding of what triggers our unhelpful responses, develop equilibrium and reconnect with our personal energy and power to create positive change in the world. 

Throughout our restorative approaches we need to practise self-compassion, not beating up on ourselves for any shortcomings or shortfalls.  Louise Hay recommends that we practise the affirmation, you’re always doing the best you can with the understanding and awareness and knowledge you have.

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Image by NickyPe from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Reduce Emotional Inflammation with Reconnection to Nature

Tami Simon recently interviewed psychiatrist Dr. Lise Van Susteren on Emotional Inflammation as part of the Insights at the Edge podcast series.  Lise drew on her newly published book co-authored with Stacey Colino, Emotional Inflammation: Discover Your Triggers and Reclaim Your Equilibrium During Anxious Times.  While the book was written before the onset of the Coronavirus, it is made even more relevant in these times of the global dislocation caused by the pandemic.  Lise maintains that emotional inflammation existing before the outbreak of the Coronavirus has been aggravated by the virus and its flow-on effects such as anxiety and grief and the unnatural states of social isolation and social distancing.

Prior to the onset of the Coronavirus, people were experiencing emotional inflammation as a result of our global and local environments impacted by climate change, gun violence, racial and refugee discrimination, economic disparity and turbulent economic conditions.  Lise acknowledged that the pre-existent emotional inflammation has been exacerbated by the advent of the Coronavirus.

She described out current conditions as a “fraught inflamed time” and encouraged us to be kind to ourselves and others as we work our way through the many challenges confronting us on a daily basis.  Lise maintained that individuals will deal with the challenges in different ways, e.g. some will keep themselves busy and get engaged with community work such as The Care Army, while others will use the time to retreat, read and reflect and/or listen to encouraging and inspiring podcasts.

Loss of connection to nature

I have previously discussed the impact of  the “nature-deficit disorder” and the loss of connection to nature and its healing powers.  Lise, who is a renowned climate change activist, argues that much of our emotional inflammation is caused by a loss of harmony with nature and its natural energy flows.  We have not only devastated our ecosystems (and the “immune system of the environment”) but also lost our capacity to be attuned to nature and its tranquillity and timelessness.

We have become time-poor, impatient, intolerant and stressed by the pressures that surround us and, increasingly, by the technologically paced character of our lives.  We refer to “slow mail” and “running out of time” on a consistent basis as our communications have increased in speed, simultaneously with increased expectations about response times and constant exposure to information overload – we are drowning in information and unrealistic expectations.

Lise is a firm believer that our ecology impacts our biology and she bases her assertions on sound scientific evidence.  She is at pains to point out that climate change has a devastating effect on our physical and mental health, a perspective reinforced by the American Psychiatric Association (APA).  Our physical and mental health is intimately linked to our connectedness to others and to nature.  Connection is a deeply felt need and frustration of this connection leads to physical and mental illness, including depression, ill-health and anxiety.

Reflection

Emotional inflammation is strongly associated with disconnection from nature.  Reconnection with, and respect for, nature can bring many health benefits and reduce the enervating effects of this “fraught inflamed time”.   Mindfulness practices involving breathing can help us to become better attuned to nature and more at peace with ourselves and others.  Nature is a rich source of healing and time spent being mindful in nature can assist us to develop the equanimity and creativity we need to navigate the unprecedented challenges of our time.  As we grow in mindfulness through meditation on nature, mindfulness practices and reflection on our way of living, we can begin to realise the critical role that nature plays in our health and wellbeing.

Peter Doherty, Nobel Prize winner for his work on infectious diseases, suggests, like Lise, that there are opportunities to be taken, and real lessons to be learned, from the current challenges of the Coronavirus:

We need to take this opportunity to rethink how we live in the world, what’s of value to us and start to look at what is really important. (Interview quoted in the Australian Financial Review, 9-10 May 2020, p.37).

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Image by NickyPe from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.