September 2022 – PLC Blog

Positive Changes after Bereavement: Is that actually possible?

In my last blog on Grief, I talked about how you can grow from grief. It sounds bizarre to suggest that something so horrible can lead to positive growth, but it can.

It is important to note that not everyone who grieves will experience positive growth. But a lot of people do.

POST TRAUMATIC GROWTH

You may have heard the term “post traumatic growth”.

This term has been gaining popularity amongst workers in the trauma field. It is the idea that trauma is not always negative. It can also have a positive aspect where the person grows in a positive direction as they recover from their trauma.

BUT THIS IS TRAUMA I AM TALKING ABOUT, NOT GRIEF.

Grief is a traumatic experience and it is included in discussions about post traumatic growth.

Trauma is a highly stressful event that often results in a negative response. Researchers have found that your brain manages the stress in the same way that positive changes can be made in the brain.

What this means is that it is possible after a highly distressing traumatic event to have negative and positive growth.

It is well known that crises in life lead to distressing emotions and it is not unusual for you as you experience these emotions to feel anxious and frightened. You may also feel sad and depressed. These feelings can continue for a long time.

Grief is one of these life crises and it is well known that sadness, a deep longing (otherwise known as yearning) for the person and wishing the person was still alive are common. Feelings of guilt, anger and irritability are also commonly observed in people who are grieving and you may be experiencing these feelings too.

These same experiences are also common in people who have suffered other traumas.

HOW CAN I GROW WHEN I AM SO DEVASTATED?

There is a widespread that trauma always results in negative consequences to the traumatised person. But research has also shown that growth also occurs. In short, that distress you feel can coexist with growth.

Many people feel they go backwards when they suffer grief and for a time that is probably true. But post traumatic growth is not just a return to the way you were, it is actually an improvement that in some people is very obvious.

IS POST TRAUMATIC GROWTH THE SAME A RESILIENCE?

Before I answer that question it is important to acknowledge that grief is not just an intellectual pursuit. Many people try to intellectualise it and fail. Grief is also experiential. You need to allow yourself to experience it in order to process it.

Resilience and Post Traumatic Growth, along with hardiness, optimism and a sense of coherence are personal characteristics that provide the ability of the individual to manage difficulties effectively.

Resilience is the ability to bounce back and continue with life after a difficult event.

Hardiness is an ability to commit to things, control self and face challenges that occur in life. Characteristics of hardiness are considered to be curiosity, being proactive, having a strong belief in your personal effectiveness and being willing to face challenges positively.

Optimism is where you consider positive outcomes will occur … eventually.

A Sense of Coherence is where you have the ability to understand events, can cope with them and even find meaning in them.

Post Traumatic Growth refers to the ability to change and not be damaged by life’s stressful events. This is where you are able to transform your life.

WHAT GRIEF TRAUMA DOES TO YOU

Grief trauma causes you to be somebody else. After a traumatic event it is not possible to go back to being the you that you were before.

It causes you to rethink all that you have previously believed about the reliability and fairness of your world.

You may find the people you thought would stand by you melt away and the ones who support you were people on the periphery of your friend circle. So many people report family rifts opening up and long term friendships ending.

All these changes in the people around you add to the sense of the world you knew ceasing to exist.

You are likely to experience a loss of trust in the certainty and positivity of life.

HOW DO I GROW FROM THAT?

When you suffer such a traumatic event it will always be remembered as traumatic. How can it be okay that this person you loved so much has died?

What researchers have found happens is that, without making a decision to, you will over time make meaning out of this traumatic event.

HOW DOES POST TRAUMATIC GROWTH WORK?

There is within everyone a drive to survive. That drive is now known to continue to operate in the brain even when there is a trauma being experienced. In other words, your desire to survive is existing in your brain alongside your distress as this traumatic event.

This is how it is possible to derive meaning from the event, even when it is so distressing.

As your brain works to survive this distress, your brain is also finding new understandings of the world. It is coming to terms with the uncertainty and unfairness of the world and the changes in support networks that may have occurred.

What this means is that you grow in the aftermath of grief because of your brain seeking to comprehend the new reality of your life with the loss of the person you love, the loss of trust in the world and the loss of some support networks.

WHAT DOES POST TRAUMATIC GROWTH LOOK LIKE?

People who report experiencing this growth report they:

• Feel an increased appreciation of life in general

• Develop more meaningful interpersonal relationships

• Possess an increased sense of personal strength

• Experience changed priorities, and

• Have a richer existential and spiritual life

WHAT SUPPORT CAN I OFFER YOU TO FACILITATE YOUR POST TRAUMATIC GROWTH?

Research has shown that post traumatic growth can be aided by the presence of supportive others to listen, assist you to craft narratives about what has happened and help you explore different perspectives. I will not tell you that in your initial sessions. It is just a process I understand you may undertake at some time.

At first you are likely to be feeling very emotional. You may spend more time crying than talking. That is totally normal and my counselling sessions are safe places for you to cry and express your emotions.

There will come a time when you will be ready to talk about other things some of the time.

REBUILDING YOUR WORLD

Because grief shatters your world you have to rebuild it. Part of this process is examining what the world means to you now. This is an existential experience and you need a counsellor who is comfortable with existential processes. As an existential therapist I am very comfortable with those at times difficult explorations. I can hold that space for you as you explore beliefs and concepts that may seem strange and even scary.

You may experience spiritual challenges and you need someone comfortable with those discussions. This is something I am very experienced in.

TELLING YOUR STORY

It is also important you are able to tell your story and be heard. Society often imposes limits on what the bereaved person is able to share. Many people feel constrained to share their feelings and are afraid to cry in public.

Being heard involves being allowed to talk without the other person telling you their story, or trying to solve your problem, or trying to offer platitudes such as “they are in a better place”, “its all for the best” and so on.

I will listen. I may ask you questions to help you to explore things further, and I will definitely summarise what you are telling me so that you can be sure I am listening to you.

FINDING THE SAFE PLACE TO EXPRESS YOURSELF

It is vital you are able to find somewhere where it is safe and acceptable to cry and share your feelings. Where it is acceptable to share and reshare your stories. This process is vital for processing your grief.

Different people have different needs around how much sharing is needed. Some people are fortunate enough to find a group of family/friends or a support group to allow them to talk and cry without censure. This type of support needs to be long term and consistent. It is unhelpful if family or friends become tired of hearing the stories and stop being supportive. It is also unhelpful if sometimes you get support and other times you are shut down.

Connection to a mutual support group can also be helpful. Being able to share with others who have been through what you are experiencing can help you feel okay to accept new ways of being.

CRAFTING A NARRATIVE

Narratives form a large part of your life and how you see yourself in the world. From family stories of events to your own stories of experiences you are always constructing stories (narratives) about your life. When someone you love dies you will construct many stories about their death, the events that occurred after that, the events in your life together and stories told to you by other people.

In a session with me you will be encouraged to share the narratives that seem important to you. You may not be aware you are doing it. Telling me about the events around your loved one’s death may not seem to be a narrative, but it is.

Narratives are useful in that they guide you to examine questions of meaning around your loved one’s death.

Narratives are not just facts of the events, they also include a lot of emotions. Sharing your narrative allows you to explore those emotions in a supportive environment.

RUMINATION AND HOW IT HELPS

Rumination is often seen as a negative in mental health. This is because the act of replaying negative stories and thoughts (rumination) is seen as being detrimental in depression.

Grief, however, is not depression. The sadness around grief may look like depression but it is not.

People with depression are discouraged from thinking about the negative thoughts.

With grief, however, researchers have discovered that this constant rehashing of events and feelings is beneficial in helping you to make sense of events, problem solve, reminisce and anticipate the future.

According to these researchers rumination in grief and other traumas is conscious, revolves around the event, and involves seeking to achieve a goal or the sorrow around a goal that has not been achieved.

In grief you are thinking about the past and that is something that needs to be worked through. You will also think about the present and the things now that are impacting you. They also need processing. You will also be worrying about what may happen in the future.

THERE ARE ALWAYS MORE LOSSES THAN JUST THE DEATH OF YOUR LOVED ONE.

As you process your thoughts about the loss of your loved one, you will reflect on past events and process anything that has remained unfinished. That is important in processing the grief.

You will also process the things that won’t happen. Examples include:

• You may never achieve your goal of a wonderful trip you had planned with your loved one.

• You may never get to grow old together.

• You may never have children together, or grandchildren, depending on your age.

These losses need to be processed as well.

BEFORE, AFTER AND THE POINT IT ALL CHANGED

In time you will likely find you divide your past into the time before your loved one died, the event of their death, and the time after. You will likely reflect late that the event of their death was a turning point in your life. Nothing was ever the same again. This doesn’t mean the turning point was something positive. It just was a point when your life changed.

There may come a point where you are able to recover the self esteem you may have lost as a result of your grief. You may find you wake up one day and realise you want to make changes in your life and you have the power to do that.

You may also accept the importance of looking after your needs. Part of this process may involve ending relationships that don’t help you anymore.

You will most likely realise that you are responsible for your own healing and your own journey.

None of this is easy, but it is possible if you want it. Enlisting the support of a trained grief counsellor to guide you through can really help.

HOW TO CONTACT ME

If you would like to talk to me about how I can help you with your grief, please contact me on 0409396608 or nan@plentifullifecounselling.com.au

If you would like to learn more, I write a regular newsletter with interesting information, tips, information on courses, and the occasional freebie. At the moment I have a free mindfulness meditation for anyone who signs up to my newsletter. This meditation offers a way to safely explore your feelings and learn to be okay with them. If you would like to subscribe please click on the link here: http://eepurl.com/g8Jpiz

Mental Illness v Mental Injury

I was challenged by an online video by Luke Chao.

In it he discussed the terms mental illness and mental injury.

He spoke about the way we perceive accidents involving physical injury compared to accidents that involve mental impacts.

A PHYSICAL INJURY

He gave a scenario where you are walking down the street and someone runs up to you and slashes your arm. You are hurt and bleeding but you are not sick. Apart from the injury to your arm you are otherwise healthy. No one blames you for being slashed. After all, that is victim blaming, something we are increasingly aware of and seek to avoid doing.

COMPARE THIS TO A MENTAL INJURY

But someone who is suffering from a mental injury is not given the same respect. If you developed PTSD as a result of this random attack you would be described as being mentally ill. This implies that there is something wrong with you, rather than there being something wrong with the people around you or your environment. In the case of the slashed arm, something is wrong with the person who randomly decided to slash your arm.

Suddenly you are being victim blamed. But isn’t that something we try to avoid doing these days?

PHYSICAL INJURIES BUT MENTAL ILLNESS

If you have arthritis in your knee but are otherwise healthy, you just have arthritis in your knee.

If you have anxiety about social situations but are otherwise healthy, you are mentally ill.

Using the term mentally ill suggests there is something wrong with you as a person. The connotation drawn from that term is that you have something wrong with you and you are ill.

Why is there such a difference between physical ailments and psychological ailments?

WHAT COUNSELLOR’S STUDY IN THEIR BACHELOR DEGREES

Luke’s comments reminded me of the rationale behind the subjects I studied in my counselling degree. We not only studied counselling, but also psychology (to better understand behaviour) and sociology (to better understand the environment). We were always taught that we needed to understand the context of a person’s environment and the impact of the people around them to understand what was happening to them.

A HORRIBLE WAY FOR YOU TO BE TREATED

If you walk into my practice room and I just see you as mentally ill, then that implies I just see you as being wrong, at fault.

If I see you as being the cause of your suffering then I don’t look further than you. I pathologise your suffering. I look for dysfunction in you and set out to correct it.

THE WAY I TREAT YOU

But that is not what I do.

Instead, I see your suffering as the result of an injury that has resulted in a completely normal reaction to abnormal circumstances. Sometimes there is more than one injury. Sometimes the injury keeps happening again and again, or has in the past happened again and again.

I look at your environment, including the people in that environment. I look to see how that impacts on you and your suffering.

I believe every person who walks through my door is someone who has been injured as a result of abnormal circumstances. I see you as being a healthy individual who is coping as best you can with a wound.

Interestingly the Greek word for wound is trauma.

Makes sense doesn’t it.

NEED HELP WITH YOUR MENTAL INJURY?

If you would like to talk to me about how I can help you with your mental injury, please contact me on 0409396608 or nan@plentifullifecounselling.com.au

Is it wrong to grieve?

If you listen to other people, or read about grief in the papers, or visit a mental health practitioner with a mental health care plan, you may form the opinion that it is terribly wrong to grieve.

From the number of people who walk through my door with this belief I consider it highly likely that you too have developed that opinion.

Back in the late 1800s Sigmund Freud formed his theories around mental health. He theorised that people were not capable of having more than one relationship and had to break their connection (referred to as “bonds”) with the dead so that you could form new relationships.

This was accepted by generations of psychiatrists and psychologists after him. Of course, it then became generally accepted in the community.

It was fairly natural for that to flow on to a belief in the post World War 2 era for acute grief, the turmoil and devastation in the immediate aftermath of the death of a loved one, to be seen as a psychiatric syndrome.

Instead of being a natural and understandable process, grief suddenly became evidence of a serious disorder.

People were judged by “how well” they were grieving. Some were seen as grieving “better” than others. Those considered to grieve “less well” were labelled as pathological, unresolved, prolonged, chronic and complicated and more …

Suddenly the understandable symptoms of deep sadness, emptiness, nothingness, depression and other behaviours were defined as suffering from a psychiatric disorder.

The whole think is ridiculous, and modern theories around grief largely debunk this, but the belief persists.

A big example of this is that the two international systems to define mental health conditions, the DSM and ICD both include a condition that labels grief as being pathological if the person shows symptoms of grief as little as 6 months after the loss of their loved one!

So people encounter a belief amongst the community and medical/mental health professionals that they are suffering from a mental health disorder and should seek mental health support.

I remember a few months after my mother died that I mentioned to my brothers that I still missed my mother. Their response was that I obviously needed mental health intervention for my unhealthy feeling!

I have lost count of the number of clients who come to me with referrals from their GP that lists them as having a pathological grief reaction when their loved one has only died in the past few months!

I don’t normally use so many exclamation marks, but I find it astonishing, disheartening and horrifying that, rather than getting support, people are pathologized and intervention requested to “cure them of their pathological grief”.

If you come to me telling me that you are still crying a few months after the loss of your loved one I will tell you that this is to be expected and perfectly natural.

I will then talk to you about what current theories say about grief. I will throw in some neuroscience in a readily understandable form to explain how normal your experience is from a neuroscientific perspective. Yes, your brain has a lot of work to do processing grief. It is not pathological for any part of your body to have to make changes. That is your body doing its job.

I will also be curious to understand any fears you may have about crying in public or being visibly upset. A lot of people have that fear because of societal conditioning that says there is something wrong with you if you still cry after the funeral instead of “getting on with life” (whatever that means).

If you come to see me a year or more after the grief and express how you just want to stop crying I will discuss with you the place of sorrow in grief. How research shows that it is possible to feel the desolation of grief alongside the act of moving forward in life.

MORE INFORMATION TO COME

There is so much to say on this subject.

I will be continuing a discussion on this in my subsequent Monday blogs.

I will talk about “continuing bonds” and their role in evaluating your grief.

I will talk about the overlooked intellectual side of grief and how that has been derailed and pathologized.

I will talk about the growth you will make during your grieving and the role of post traumatic growth in this.

I will talk about how desolation and growth can exist together

I will also talk about sorrow, pining, yearning and the “depression” experienced as part of grief.

I will also talk about solace and its role in grieving.

These are all important things to discuss to understand what is happening for you, how okay what you are experiencing is, and how to avoid being pathologized by mental health professionals and society in general over your totally normal grief.

If you would like to talk to me about how I can help you with understanding your grief, being reassured you are not going mad, and surviving the unhelpful interventions of others, please contact me on 0409396608 or nan@plentifullifecounselling.com.au

Ways Children Grieve Differently

There is a general lack of understanding around how children grieve.

People expect children to grieve the same way adults do. For that reason, when the child is seen to happily play it is assumed they have “gotten over” the death of their loved one.

But this is not so.

UNRESOLVED GRIEF IS FREQUENTLY THE ENEMY WITH GRIEF IN CHILDREN

Many adults consider grief the enemy to fight, and therapy to support people in that situation often aims to help people see grief differently. However, with children, unresolved grief is the enemy. Why? Let me explain.

WAYS A CHILD GRIEVES

How a child grieves is determined by a number of factors:

• Their developmental stage,

• Their age,

• How the loved one died,

• What they have already experienced in life, and

• How they see grief modelled by the adults around them.

Researchers have observed that children move in and out of grief. They also need to handle their grief in small periods of time and intensity.

BRAIN DEVELOPMENT IMPACTS ON A CHILD’S WAY OF GRIEVING

One of the main reasons children grieve this way is to do with their brain development and the coping skills they have developed.

Children’s brains develop the ability to cope with overwhelming emotions in stages. Initially they need a lot of shared soothing from caregivers. Over time, they learn to soothe themselves more and need less support. However, frightening events and highly emotional occasions still require a lot of assistance in shared soothing from caregivers.

HAVING A BREAK FROM INTENSE EMOTIONS

Even adults cannot spend 24 hours a day grieving. Much as you may not want to think about anything other than your lost loved one, the reality is you do think about other things.

Just as the child needs breaks from the intensity of emotions, so do you the adult.

This is referred to as dual processing. You have grief to attend to, and you have life to attend to. So you work out a balance between the two. Children do the same, just in smaller doses that their brains allow.

DEVELOPMENTAL STAGES CAUSE THAT GRIEF TO BE REEXPEREINCED

The other thing that happens with children and grief is that the child will often reexperience that grief at different developmental stages. Don’t think that the child will be over the death after a few years. They will often reexperience their grief later in childhood and even into adulthood.

The general rule for children is that under the age of 4 the child will know someone is missing and miss them. They will know there is something wrong. They can’t however really understand what they are experiencing and why the loved one is not there anymore.

HOW TO SUPPORT A GRIEVING CHILD

They will need lots of cuddles from trusted caregivers at the time. As they grow older they will have more questions and much more sadness as they understand more about death and the death of this loved person.

UNRESOLVED GRIEF

When the adults in the child’s life avoid talking about the grief, the child is unable to process the grief and it becomes unresolved grief. They will then often hide their feelings away.

You may see acting out behaviours, depression, anxiety, and disorganisation. You may see anger, often directed at you. These are often signs of unresolved grief that has been hidden away but now needs to be expressed and acknowledged.

EACH GRIEF PILES ON TO THE NEXT ONE

Children don’t only experience grief at the time of their loved one’s death. They also experience this grief at different developmental stages in life. When someone else dies the grief over the previous grief will also be experienced. In fact, we all grieve for the current grief and any past ones that have happened.

NOT BEING ABLE TO SAY GOODBYE

One thing I have found when working with adults still trying to process the death of loved ones in their childhood, is that they were often not included in the death and aftermath of this loved adult. Often children were sent away to stay with relatives and did not see their loved one as they were dying. They are often not included in the funeral. So their opportunity to say goodbye is denied them.

FEELING THE DEATH IS A TABOO SUBJECT

Children can often feel the adults in their life do not want to talk about their loved one. So they lock away their feelings, which are expressed in other ways.

When a child is young when their loved one dies, they are often not able to express what they are feeling. Even if they are there to see their loved one as they are dying and attend the funeral, they will still experience the death differently as they grow up.

FEELING GUILTY ABOUT THE DEATH

Children can also feel guilty about their loved one’s death and will hide that away out of fear the other adults in their life will reject them if they know.

BEING TOLD TO LOOK AFTER THEIR PARENTS

One of the saddest things I have seen happen with children is when adults in their life tell them to look after their mother or father and be responsible. Children in that situation often feel they are not able to grieve for their loved one and must suddenly become adults responsible for the welfare of their parent/s.

ADULTS MODEL GRIEVING FOR CHILDREN

Research has shown that children will grieve based on how their parents grieve. If adults are open and honest about their feelings and encourage their child to share theirs, with opportunities to comfort each other, then the child will feel more comfortable sharing their grief when it resurfaces.

THE CHILD BELIEVES THEIR GRIEF IS NOT IMPORTANT

If adults hide how they are feeling, thinking it is better for their children, the children can feel it is not okay to express their grief. A child will also hide their grief if the adults in their life don’t respond to their expression of grief and instead become extremely upset without acknowledging the child’s experience. Some of that hiding is due to fear of upsetting the adults in their life. Some is also due to the child forming the belief that their grief is not important. This will be particularly so when someone has told the child to look after their parent/s.

HOW ADULTS CAN HELP

Children need adults who can openly and honestly discuss grief, how it is for them (in age appropriate language and content) and be open to asking the child how it is for them.

EXISTENTIAL QUESTIONS – WHAT IS DEATH?

The first time a person encounters grief there is a massive existential shift needed to understand it. At any age, even in adulthood, people question what grief means. This is more so for children and their developmental stage will impact on how they explore that question. It is important to be open to answer any questions a child may have and to be prepared to have an age-appropriate conversation with the child if they wish to have one.

Don’t be afraid to name what led to the death of the loved one. For example, if the child’s grandfather died of cancer, you may explain that he had a sickness in his body that caused it to stop working. So that the child doesn’t worry that they may get that sickness too you can explain to them that they do not have the sickness and are well.

QUESTIONS AND HOW TO HANDLE THEM

Children will often ask questions about where their loved one is. People have many different beliefs around death. I find children are particularly concerned that their loved one is with any pets they have lost, or with another loved one. They don’t want them to be alone. They may also want to know if they are still sick, in pain, scared, sad. Understanding that helps with responses around your beliefs.

One parent who brought their child to me spoke of having read the experiences of people who had near death experiences and used this to tell their child that their grandfather was in a very happy place with his parents and siblings and old friends, as well as the family guinea pig and dog.

THE FORM THERAPY TAKES AND WHAT YOU CAN DO AT HOME

Children are more open to express their feelings and understandings in play where the child may play out scenarios that help them process their loved one’s death. Allowing them to play and not shutting down their play can be really helpful to them. Reading age appropriate books about death are also very helpful. Drawing is another way children often express themselves.

THINGS TO REMEMBER

Remember, it is most important to allow children the space and permission to grieve. Don’t force them to talk if they don’t want to, but model openness around your own grief journey and an openness to listen when they want to talk.

Do not make the loved one a taboo subject!

Be prepared for the grief to resurface at different developmental stages.

Get help if you feel your child is not coping with immediate or resurfaced grief.

Ensure you get help for your own grief needs.

If you would like to talk to me about how I can help you or your children with grief, please contact me on 0409396608 or nan@plentifullifecounselling.com.au

R U OK?

Today is RUOK day.

RUOK day is not only about reminding you that you have the power to help others, but also a reminder to seek help is you are not OK.

Helping others is not just the preserve of those of us who specialise in mental health. We all can help others.

Today I am going to talk about how to ask others if they are OK.

Then I am going to talk about how you can get help if you are not OK.

Most people will not ask for help. Such help seeking is pretty taboo in our society. Have you ever been taught even the basics of a foreign language? If you have you will no doubt have started with how to greet another person. Hello. I am xxx. How are you? And you will not doubt have been taught the response: I am well thankyou.

This is the hidden message of our culture. Don’t tell others how you are feeling!

I am sure you have met people who will avoid any discussions that are hard. These are the people who will avoid responding to your tentative words reaching out for help. Or who will respond with comments designed to stop the conversation.

If you are in that position, don’t give up. Later in this blog I will talk about what you can do to be heard.

WHAT SHOULD I BE LOOKING FOR IN THOSE AROUND ME TO INDICATE I NEED TO ASK RUOK?

Because of the taboos in our society on reaching out to others, it is unlikely a person who needs help will tell you – unless you ask.

The following are times in a person’s life when they might need a little bit of extra help:

• When a relationship has ended or there are difficulties in that relationship.

• When the person is going through stressful times, or there has been an increase in the stress in their life.

• When there are financial difficulties.

• When there are major changes in the person’s life either at home or work.

• When someone/thing they care about has been lost.

• When there is a major health issue.

• Any time you notice someone is struggling.

SIGNS A PERSON IS STRUGGLING

• Things they are saying, especially if they are different:

 o    They may not be making any sense when they talk, as though they are confused.

 o    They may tell you they can’t cope or feel things are out of control.

 o    They may criticise others or themselves.

 o    You may get the impression they are feeling trapped or in emotional pain.

 o    They may tell you they feel lonely or are a burden to others.

• Things they are doing that may be different:

 o    They may seem to lack energy or be unmotivated

 o    They may be unable to switch off

 o    There may be changes in how much and when they sleep, exercise or eat.

 o    They may appear uninterested in their appearance. This may extend to their home.

 o    They may no longer be interested in the things they used to enjoy doing.

WHAT DO I DO IF I THINK SOMEONE IS STRUGGLING

If you think someone is struggling then this is the time to consider asking them if they are okay.

Before you do this it is a good idea to consider how or if you might have that conversation with this person.

If you ask the wrong way, and are not prepared for a helpful conversation, you may not help the person. If you feel you are not able to ask, maybe finding another person to ask may be helpful. This is not saying you are not going to be any good at it, but maybe the situation the other person is in , or the relationship you have with them may impact any conversation you may have.

The other person needs to feel they can trust you, or they will not open up to you. So it is wise to consider whether you have been trustworthy in your relationship with that person.

If you feel the other person can’t trust you, you may still be able to reach out to them. In this situation it is best to acknowledge the past. Maybe you could try saying something like:

“I know I haven’t been very trustworthy in the past, but I am concerned about you and I care that you may not be feeling okay.”

If your previous conversations with this person have not involved you listening very well, you can maybe try saying:

“I know I haven’t listened to you very well I the past, but I am concerned that you may not be okay and I want to listen and hear you and support you.”

HOW TO PREPARE TO ASK RUOK

First step is to be ready:

• Ask yourself if you are in the right headspace to listen.

• Ask yourself if you are willing to really listen to the other person.

• Make sure you have the time to have this conversation. It is no good asking someone if they are okay and then rushing off because you have to be somewhere else.

Second step is to be prepared:

• Acknowledge that you are not there to “fix” the other person. You are there to listen. It is okay if you don’t have any answers to their difficulties.

• Don’t rush the other person or fire off questions at them. Be prepared to sit quietly and non judgementally with the other person and allow them the space to process their thoughts and express what they want. When you are trying to survive you spend a lot of time pushing down emotions so you can get through the day. It may take time for the other person to feel able to speak about something that they are feeling very emotional about. It is helpful to bear in mind that it is often embarrassing to discuss problems.

Last step is to choose your moment carefully:

• Find somewhere private and comfortable. A busy place with little privacy is not going to be very conducive to expressing vulnerable thoughts.

• Is this a good time for them to talk? If they are busy and stressed, they are not likely to be willing to take the time out to express how they are feeling.

• You may need to choose another time if they are too busy to talk.

• Consider the way you talk. It is often less threatening when you are sitting side by side doing nothing that requires concentration, or when walking. Being side by side is less confronting than being face to face.

The last point on being side by side highlights the value of being with the other person and doing something together. This is a great time for a conversation where the other person is likely to feel comfortable and able to talk.

IMPORTANT TO CONSIDER

You may be ready to reach out to the other person. But they may not be ready to talk.

Don’t give up. The fact you reached out and expressed your concern will not be lost on the other person. It may be that when they are ready to talk they wil reach out to you.

It is better to have asked than not to have asked. If you ask and they say no, at least you asked. If you don’t ask you will never know if you gave up a wonderful opportunity to reach out to someone in need.

NOW TO ASK – R U OK?

Have a casual conservation.

Start by saying something about what has prompted you to ask.

Examples include:

• You have been quiet lately, how are things going for you?

• I haven’t seen you much lately, is everything going okay for you?

• You’ve seemed really stressed lately, do you want to chat about something?

Now listen and don’t jump in with your own stories.

THEY DON’T WANT TO TALK TO ME – WHAT DO I DO?

Just because you reach out to another person does not guarantee they will talk to you.

It may be the wrong time for them to talk. You could try asking them if it would be okay to check in with them again.

They may feel no one cares and may need to process you request before they are willing to accept you invitation to chat.

Maybe they would feel more comfortable talking to someone else.

You reaching out may lead to them reflecting on their need to talk and they may be willing to talk to or someone else at another time.

THEY DO WANT TO TALK TO ME – WHAT DO I DO?

They welcome your question and tell you about their problem.

So what do you do?

• Remember we talked about you being there to listen, not solve problems.

• Listen.

• Don’t rush to judgement. Have an open mind.

• Give them space to talk. If they pause, don’t rush to fill the silence. Silence is great. Allow the silences and trust the person will talk when ready.

• Ask questions that are open ended, that is that don’t require yes or no answers.

• Ask them to explain the things they say. Don’t assume you understand what they are saying or the impact it has on them. Do this by asking questions that allow space for them to answer in many words. No questions that just require a yes/no. They shut down the conversation.

• Every so often repeat back what you have heard them say and ask if you understood it properly. This give them a chance to correct any misunderstandings and sends the message that you are listening.

I HAVE LISTENED AND THEY HAVE TOLD ME ABOUT THEIR PROBLEM – NOW WHAT DO I DO?

It is at this point you can encourage them to explore what they might be able to do to help themselves.

This may involve someone they can seek help from. It may instead involve spending time together brainstorming ideas on what they may be able to do to change their situation.

Maybe they might see their doctor, talk to a family member, talk to a close friend they trust, see a counsellor.

They may have encountered difficulties in the past and been able to solve them. What did they do back then? Is this something that may work now?

You can also ask them if there is anything they need from you.

CONVERSATION OVER – NOW WHAT?

Once the conversation is over there is still one thing you need to do.

That is to check in with the person at another time.

Let them know you haven’t forgotten them and are still willing to support them.

This allows you to communicate to them that someone cares.

It allows them to feel less isolated.

It may be the encouragement they need to do something about their situation.

It can support them until they are ready to reach out for professional help.

I THINK THEY ARE AT RISK OF SUICIDE – WHAT DO I DO?

If you are concerned the other person is suicidal don’t be afraid to ask.

It can be as simple as “are you thinking about killing yourself?”

Asking will not plant the idea in the other person’s mind. If they are suicidal they already have that idea. If they are not suicidal your asking will not suddenly make them suicidal.

If they answer YES this is what is important for you to do.

Do not leave them alone. Keeping them safe is important.
Get professional help.

While you stay with them:

Keep listening to them.

Find out if there is someone they trust who can help them.

Not all people who are suicidal will actually kill themselves. You can ask if they have a plan and the equipment needed to carry it out.

Unless you feel they are in immediate danger (in which case you will dial 000) try the following:

• Call a crisis support line together.

LIFELINE: 13 11 14

SUICIDE CALL BACK SERVICE 1300 659 467

who provide immediate support and advice

• Visit an emergency department together.

• Take them to a place they feel safe where they will not be alone.

HOW DO I GET HELP IF I AM NOT OK?

Reach out to someone you feel comfortable talking to.

If someone reaches out to you, be willing to accept that offer of help.

If you urgently need to talk to someone, or you are feeling suicidal, LIFELINE 13 11 14 is a good starting point.

You can also ring the SUICIDE CALL BACK SERVICE 1300 659 467

For longer term help counselling can be very helpful.

If you would like to talk to me about how I can help you when you are not okay, please contact me on 0409396608 or nan@plentifullifecounselling.com.au

RUOK.ORG.AU IS A GREAT SOURCE OF ADVICE ON HOW TO ASK RUOK

How to Survive Grief

“I am sick of feeling sad all the time.

Can you wave your magic counsellor wand and make me feel better?”

Okay – the first sentence is one that is commonly spoken to me by people who are struggling to “move on” from their grief.

When they say move on, they are not referring to some rule that says they must get better but an expectation others may have placed on them or their own expectation.

Some people are just sick of feeling this way and want to move on.

The second part of that statement isn’t ever spoken but I frequently get the impression that is what is wanted.

And who wouldn’t.

On my grief journeys I have certainly wanted some kind fairy godmother to come along and wave her magic wand so that I can get back into my life.

Can you relate to this?

NEVER GOING BACK TO HOW IT WAS

I speak often of the fact that there is never any going back. Our lives are one way. We can never go back.

 Every step in life is a step forward that has no return.

 Every step in life involves you changing to match that step.

It is just that in the normal course of life you don’t notice how you have changed.

Most people find that they look back nostalgically on past times and wish they were back there. But that can never happen.

Once someone you love dies, your life changes more obviously than at other times. No matter how much you want to go back you never can.

REALITY EVEN IF YOU DON’T WANT IT IS STILL THERE

Life has changed and so have you.

 The reality is that you will keep living.

 The reality is that you will learn to live with the life you have.

 The reality is that the life you have will not be the life you had before your loved one died.

No matter what, you will get through this dark time in your life.

You may not want to, but you will.

MAKING A CHOICE … IN TIME

How well you move through this time into the rest of your life will depend on your choice to survive and get through this time.

Are you willing to do that?

I am not saying that the minute your loved one dies. Those moments when you feel numb and the world seems so unreal and foreign. Those days when you can’t seem to stop crying. Are the time you make that decision to get through it.

In the immediate aftermath of bereavement your brain and body are dealing with the enormity of your loss.

Give them time.

Later. When the numbness and pain have started to subside and you feel you might be able to get up, notice a pretty flower, talk to a friend you may find yourself willing to make that decision.

It will probably take months, and months.

ONE PERSON’S EXPERIENCE USING GRATITUDE

Sandy* came to see me after her father died.

His loss was devastating, and she missed him desperately.

She loved writing and I encouraged her to journal her feelings.

One day, about 6 months after her father died, she was journalling and found herself overwhelmed with sadness at her father’s death.

Sandy had practised gratitude for years. At that moment her gratitude habit kicked in and she found herself writing down all the things she was grateful for.

After that she wrote about all the things in her life with her father she was grateful for.

After this exercise she found herself focusing on the happy memories instead of the great loss she had suffered.

She made a conscious decision to remember her father in happy moments in life, not as he died at the end.

Every time she thought of her mother she chose to remember the happy moments.

She practised this so much that she found she automatically remembered the happy moments whenever she thought of her father.

Those happy memories helped her to see the wonderful things about her mother’s life.

She continued to acknowledge her sadness but also to list things about her father that she was grateful for.

Over time she found that instead of focusing on what she had lost, she was able to focus on what she had with her father and to realise her father would always live on in her memories.

She was able to let go of the regrets at the things her father would miss and instead focus on the things her father had.

She reported being so aware of her father always being with her through her memories.

It is possible to come to a place where you can focus on what you had instead of what you lost. Where you can remember the happy times and those memories can become the default ones.

With a decision to change your focus and a generous allowance of time to grieve, it is possible to move into a time of feeling less sad and focus instead on the happy memories.

It is possible, but give yourself time to grieve first.

Sometimes you need help from a qualified and more objective counsellor. If you would like to talk to me about how I can help you with your grief, please contact me on 0409396608 or nan@plentifullifecounselling.com.au

*please note than whenever I mention someone in my blogs I never use real names and change the circumstances to de-identify the person who has generously given permission for me to use their story in my blog.

My trauma symptoms helped me survive

The effects of trauma can last for weeks, months or years. This is particularly true if the trauma occurred in childhood when major growth in the brain was occurring. This is because trauma affects the way the brain develops.

The impact of trauma can be experienced throughout life, until it is able to be processed. Even then the memory will not necessarily fade, but the impact may.

TRAUMA IS AN UNWANTED FAMILY HEIRLOOM

It is useful to liken trauma to a family heirloom. Family heirlooms tend to be old and may be passed down through the generations. By the time you get them they are often very old, even considered antiques. These items are usually greatly loved sentimentally and valued for their memories.

Trauma can be passed down through the generations too. It may be passed down in the way you were treated growing up, in the way your family related to each other, in the way you were taught to see the world, even in the keeping of secrets within the family.

Unlike family heirlooms, trauma is not something that is valued or loved sentimentally. It is often not acknowledged. But it leaves one massive elephant in the room that is very hard to hide. Although people will try.

TRAUMA’S GREATEST WEAPON IS SHAME

Shame leads people to hide the trauma in the family. This makes it very hard to heal the trauma.

TRAUMA IS FELT THROUGH PHYSICAL SENSATIONS AS WELL AS EMOTIONS AND PERCEPTION

Trauma as it has been experienced by you leaves you with intense physical, perceptual and emotions reactions to things others may feel are nothing important or frightening. These things trigger memories of past experiences. Experiences that are related to the trauma you feel.

The intense physical, perceptual and emotional responses are hard to control because they are stored in part of your memory known as “implicit memory”. These are memories deeply embedded in your memory. Memories of things you are often not aware you have experienced. Memories you have no control over.

They are not stored in conscious and manageable memory. They are stored in subconscious and therefore unmanageable memory.

The constant reactivation of these memories ensure they remain at the top of your memories on a daily, even multiple times daily, basis.

SYMPTOMS OF TRAUMA REACTIVATION

When these memories are reactivated by reminders, referred to as triggers, you are thrown into a fight/flight defence mode.

• You may feel hyperalert and hypervigilant.

• You may be aware of tension in your body.

• Your breath may feel shallow and you may be aware of your heart pounding.

• You may even have horrifying images come to mind, or thoughts warning you of danger.

• You may find yourself inexplicably afraid or angry.

• You may feel pain in parts of your body.

• You may feel isolated and alone.

• You may be aware of being anxious or feel others are against you and unsupportive.

• You may find yourself judging what is happening around you negatively.

• You may have a strong desire to isolate from others.

• You may feel frozen.

• You may find it difficult to say no to people.

• You may feel you have to please people.

• And many more experiences. The list of reactions is endless

TRAUMA SYMPTOMS ARE POORLY UNDERSTOOD

There is not much awareness of what constitutes a trauma symptom.

Many of the symptoms of trauma are not recognised as being trauma related.

Trauma survivors share many symptoms and it is possible for a trauma informed therapist to spot those symptoms.

When I work with people I often see the symptoms that that person may not be aware of.

People may come to see me because of

• difficulties in life

• anxiety

• unmanageable stress

• difficulties in relationships

• depression

• work stress

• feeling numb

• inexplicable pain

• difficulty concentrating

• difficulty making decisions

• difficulty setting boundaries

• and many more symptoms

I AM IMPACTED BY TRAUMA. DOES THAT MAKE ME DEFECTIVE?

When you realise your current difficulties are due to trauma it can lead to your feeling deficient as a person.

Maybe you feel you are weak and not as able to cope with life as others.

But the reality is you survived difficult experiences you could not deal with at the time. So you learned ways to cope, to survive.

TRAUMA SYMPTOMS ARE SURVIVAL ADAPTATIONS

You learned to adapt to the threats and danger. You learned how to cope with being too young to be able to defend yourself, or too powerless to overcome someone stronger or just being trapped.

The behaviours you exhibit now. The way you see the world now. The way you relate to people. The way you perceive the world. All these are ways you adapted to survive.

And survive you have. You learned how to behave, how to keep yourself safe in a situation over which you had no control.

The things you did were wonderful adaptations to help you survive.

I AM SAFE NOW. I WANT THE BEHAVIOURS TO STOP.

Now that you are away from that situation the adaptations are causing difficulties.

This is because you need to learn new behaviours.

It is time to heal from the past and let go of the once helpful but now constricting behaviours. It is time to learn new behaviours.

HOW DO YOU HEAL FROM THE PAST?

The Blue Knot Foundation is a peak body in trauma treatment in Australia. They have produced trauma treatment guidelines that trauma therapists follow in trauma treatment.

These guidelines are world renowned and highly respected.

They involve long term therapy conducted safely by properly qualified trauma therapists.

I have trained extensively with the Blue Knot Foundation and follow their guidelines in my work with trauma survivors.

DO YOU WANT TO TAKE THIS FURTHER?

If you would like to talk to me about how I can help you heal from your trauma, please contact me on 0409396608 or nan@plentifullifecounselling.com.au