The Lighter Side of Transformation

with Lisa Wessan, LICSW

On the “Myth of Closure,” Ambiguous Loss and Complicated Grief

“Everyone experiences ambiguous loss if only from breaking up with someone, or having aging parents or kids leaving home. As we learn from the people who must cope with the more catastrophic situations of ambiguous loss, we learn how to tolerate the ambiguity in our more common losses in everyday life.” 

– Pauline Boss, Ph.D.

In my immediate family, several of my nearest and dearest have battled with cancer over the years…both of my paternal grandparents, may they rest in peace,  my dear first cousin Stephanie (may she live to be a super centenarian) and my delightful and fierce Aunt Yvette (known as “Auntie”), who is currently receiving hospice care.  It has been a long and grueling journey with cancer for all my loved ones.

Sometimes I struggle with feeling powerless, and living so far away from my family in Sarasota, FL. When they lived in New York, it was so much easier to visit. Sadly,  I can’t make frequent visits to Sarasota. The only “power” I do have is to send intentional healing and loving energy to my Auntie and family…and to practice radical acceptance so that I will function with some measure of inner peace here in my world.

For a while, my Auntie was in and out of the nursing home while she battled her cancer and other complications from treatment. Her life was severely compromised by her illness.  As harsh as this has been is for her, since April 2015,  I have also been witnessing how Auntie’s dying process is affecting everyone around her.

My cousins are fraught with anxiety and grief. Others are a hot mess, watching Auntie dying so slowly, not being able to process their feelings and find some relief.  Some people get trapped in the “Blame Game,” and are always looking to find ways to defocus their pain by pointing at others (that’s a separate article, on the Blame Game, worth exploring soon).

We are all coping with the ambiguity of Auntie being here, yet not here.  She is no longer resembling her true self as we knew her.  Sometimes she is delirious, sometimes she is too weak to talk. As her body deteriorates, she is no longer living the full and robust life she once enjoyed.

ambiguous loss1

This pain we are all experiencing has a name…it is called Ambiguous Loss.  “Ambiguous loss is a loss that occurs without closure or understanding. This kind of loss leaves a person searching for answers, and thus complicates and delays the process of grieving, and often results in unresolved grief.” (Wikipedia)

There are a variety of types of ambiguous loss.  One type is when people go missing and the body is never found.  For example, a person does not return from a sailing trip, or from a hiking excursion, or war, or they are kidnapped.  Their loved ones still feel a lack of closure because the body was not found.   “Maybe they will return…” lingers in the mind.

After 9/11,  all of us in NYC were processing personal and professional ambiguous loss for all of our New Yorkers who were lost in the pile of bodies that were never recovered.

Another kind of ambiguous loss is when people experience a new emotional boundary that hurts.  This happens when people get divorced, or when someone ignores you, stops talking to you, shuts you out of their life.  Any kind of break-up creates ambiguous loss, because the person is still here, yet not here. They are alive, but dead to you.   This is considered more painful loss than when someone actually dies.

ambiguous loss3

Medical illness and addictions cause ambiguous loss.

Ambiguous loss also occurs when a loved one has Altzheimers or dementia, and they no longer recognize social connections. Similarly, when someone is very ill, such as my Auntie, we have ambiguous loss because the illness is transforming our loved one into someone other than the person we always knew. We are mourning the living remnants of our loved one…so excruciating and bitter.

When someone is living with an addiction, this too causes their personal relations to deteriorate and they are not fully present for their loved ones. Again, they are here but not here.

I have a friend who had a beautiful daughter in Cambridge, MA,  who chose to be homeless.  Her daughter was an alcoholic.  My friend tried all methods of intervention and help. Nothing worked. My friend suffered with ambiguous loss for so many years. Her daughter was a pianist, absolutely lovely.   She died a few years ago,  at 35, and it was one of the most heart wrenching tragedies I experienced.  My friend is still recovering from this painful loss.

Learning to live a good life with ambiguous loss

I recently listened to a wonderful and insightful podcast interview with ambiguous loss pioneer Pauline Boss, Ph.D., who originally coined the term “ambiguous loss.”   Krista Tippett hosts Dr. Boss on her podcast, On Being.  You can listen here:

The Myth of Closure [UNEDITED VERSION, 1.5 hours]

The Myth of Closure [EDITED VERSION, 1 hour]

I prefer the unedited versions of Tippett’s interviews, because there are sometimes fascinating nuances that are deleted to make the long form interview fit into an hour. But I’m sure whichever one you listen to will be rewarding!

One of the ideas I took away from Dr. Boss’ talk was that we will never have complete closure from our ambiguous losses, or from our complicated grief.  What we can do is become  more adept at processing our negative feelings and difficult thoughts. Dr. Boss has some wonderful suggestions on the process.

Cognitive restructuring, which can be learned, is a big part of the solution.  Dr. Boss’ stories and explanations are very helpful in deconstructing the different kinds of ambiguous loss that we all have in our lives.

Even though I learned about ambiguous loss and complicated grief in graduate school, it seems I keep deepening my learning about it more every year, from clients who are struggling with painful divorce, adult children with addictions, my Auntie’s battle with cancer, and for all the ongoing loss of freedoms in the world that never seems to subside.

Fun fact: Ambiguous loss is clearly part of our psychospiritual journey — for it forces us to grow and move to new levels of compassion and acceptance of things we cannot control.  “Lack of power, that is our dilemma,” says Alcoholics Anonymous  (Bill W., 1976).  Yes, in our culture, we seek to control, cure, fix and manage everyone and everything as much as possible. We don’t like messy endings.

Yet what I have come to know, is that true mastery of life is being able to live in ambiguity with peace, even joy.  My life is far from perfect…yet I am more often feeling positive, grateful,  uplifted, inspired and anticipating good interventions that will transform it.

If we can learn to live in that “not knowing” place and be peaceful — that is a vast improvement on “hating ambiguity” and perhaps yelling at G-d or the Universe, or twisting into knots over why bad things do happen to good people…again, very messy, so annoying.

The truth is, when it comes to matters of love, there is no closure. As they say at the Grief Toolbox,  “Closure is not part of the grieving process, nor is it necessary for healing. A connection formed in love can’t be closed.”  Dr. Boss confirmed this with her years of research on ambiguous loss, leading to her forthcoming book on “The Myth of Closure.”

ambigousloss5

As Dr. Boss discussed in the interview, our Western culture wants neatly packaged endings and for everyone to move on as quickly as possible.   There is plenty of shaming that goes on, as in “Aren’t you over that yet?”

Sadly, our culture does not tolerate ambiguous loss very well at all.  It requires more Eastern, dialectical thinking.  To be able to say non-binary statements such as “She is alive, but also dead,”  “He is not here, but he is possibly still alive,”  or “She looks like Auntie, but this is not Auntie anymore,” requires a leap from dualistic thinking to a more dialectical thinking which allows us to embrace opposite beliefs without sinking into a deep depression or disruptive anxiety vortex.

Solution Focused Suggestions

For today, I invite you to learn more about ambiguous loss, and start to apply these non-dualistic, non-binary, dialectical thinking ideas to your situation.

  • Listen to the podcast above, and learn some skills to help process your ambiguous grief.
  • Perhaps find a good therapist who can help you learn to cope better with your struggles.  Good news: coping skills can be learned!
  • Learn to laugh at the absurdities, paradoxes and incongruities of life (Gavin, 2010; Wessan, 2013).
  • Practice your Distress Tolerance skills …join a Dialectical Behavior Therapy group.  You may then find it easier to work through the painful moments, and allow yourself to live in ambiguity with, dare I say it, some joy!

 

Onward and Upward,

Lisa Wessan

 

References

Gavin, J. (03 Sept 2010). Laughing with the Joys and Troubles of Life Leads to Growth. The Chelmsford Patch. Found at https://mirthmaven.blog/2010/09/16/lisa-wessan-interviewed-in-the-chelmsfor/

Pauline Ross, Ph.D. https://www.ambiguousloss.com/

W., Bill. (1976). Alcoholics Anonymous : the story of how many thousands of men and women have recovered from alcoholism. New York:Alcoholics Anonymous World Services. Fourth edition, Chapter 4, We Agnostics. P. 45. 

Wessan, L. (2013).  Using Humor and Laughter in Therapy. Focus Journal. National Association of Social Workers.  Vol. 40, No. 4. 3,11.

Copyright © by Lisa Wessan 2019. All rights reserved.
www.LisaWessan.com

 

 

 

 

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How to Improve your Interpersonal Effectiveness

The full scope of Interpersonal Effectiveness focuses on improving communication, learning to set healthy boundaries, learning to validate self and others, gaining confidence in asking for what you want,  enrolling others to help you in your dreams and goals, and letting go of toxic relationships.

Below is a sample of  one of my lesson plans for  Interpersonal Effectiveness.  (This is one segment from 14 classes on this topic.)

 

Preventing Compassion Fatigue

It can very often be difficult to say no to people who make demands of us, and if we say no, we can get caught up in self-critical thoughts leading us to feel guilty. To avoid feeling guilty, we just keep on saying “yes” to every request.

Someone asks us to do something: 

Say No diagram

We can learn ways of saying “No” that don’t lead us to think self-critically or feel guilty. For example:

  • I’m sorry but I really can’t take on anything else at the moment.
  • I’m quite busy right now. Perhaps another time.
  • I’d like to help you out, but I just don’t feel up to it at the moment.
  • Thank you for asking me. You’re a nice person, but I don’t want to go out with you.
  • I don’t need a new roof (double glazing, vacuum cleaner etc). I’m happy with what I have thank you.

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  • If the person seems to have trouble accepting your “No,” then just keep repeating yourself, over and over if necessary. Be a BROKEN RECORD! Practice what one of my students calls Polite Perseverance…You might have to add the word “No” to the beginning of those statements, perhaps with some emphasis on that word. For example:
  • No. I’m sorry but I really can’t at the moment.

 

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Be wary of those self-critical thoughts afterwards. Practice challenging and/or dismissing them, by telling yourself:

  • I explained to them why I couldn’t do it.
  • It’s not my responsibility.
  • It would only end up upsetting me if I agreed to it – this is best for me. If I feel less tired and not resentful, then I might be a better position to help them out next time.

They’re just thoughts – I don’t need to pay them any attention (then put your focus of attention on something else).

The following dialectic affirmations about control and esteem can be helpful for finding that balance.

  • I cannot control some things but I am not helpless.
  • I cannot control other people but I am not helpless.
  • I am not responsible for those things I cannot control.
  • I accept those things in myself that I cannot change.
  • I can make positive choices for myself.
  • My strengths and abilities deserve my appreciation. Appreciate those abilities you have.

 

Create your own affirmations by completing the following sentences:

I am not powerless, I can ___________________________________________________

I have the right to refuse ___________________________________________________

I am not helpless, I can _____________________________________________________

I deserve to _________________________________________________________________

Remember, a wise person once said “Repetition is the mother of skill…” so aim to  repeat these phrases at least twice a day, with focused energy, enthusiasm and passion!

Onward and Upward,

Lisa Wessan

 

___________________________________________________________________________________________
NOTES:

The DBT Program in my office covers these modules:

  1. DBT Core Mindfulness [focusing skills]
  2. Distress Tolerance [crisis survival skills]
  3. Emotion Regulation [de‐escalation skills]
  4. Interpersonal Effectiveness [‘people skills’]

During class, we role play the act of saying “No” and turn these into powerful “Moves” to help you build new neural networks in your brain. We combine neurology, physiology and cognitive restructuring to do this, and sometimes add music and dancing to ramp up our energy. This  helps you develop a fresh new response more easily and will become your “new normal”  response to people’s inappropriate or untimely requests.

** For more information, please visit www.lisawessan.com 

 

Copyright © by Lisa Wessan 2019. All rights reserved.

 

 

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Moving towards wholeness with Dialectical Behavior Therapy (DBT) Skills Group, Thursday evenings in Westford, MA

Grateful Plug:

I am pleased to announce the next 14-week Dialectical Behavior Therapy Skills (DBT) Group in Westford, MA will be starting a new module on Thursday, April 6, 2017.  We will be covering both the Mindfulness  and Emotion Regulation modules.  (This is an ongoing group that has open enrollment periods three times per year.)  At this writing, there are two spots left for the next trimester.

The Mindfulness material includes:

  • Learning to be a good observer
  • Being non-judgmental
  • Staying in the present
  • Practicing non-multitasking
  • Accessing Wise Mind (aka higher self, higher consciousness or other spiritual beliefs, e.g. Christ Consciousness, HaShem, Atman)
  • Understanding Reality Acceptance and detaching from thoughts.DBT Mindfulness

The Emotion Regulation module has four sections:

  • Understanding and Naming Emotions
  • Changing Emotional Responses
  • Reducing Vulnerability to Emotion Mind
  • Managing Extremely Difficult Emotions

 

#MirthMaven |

As DBT founder Dr. Linehan says, “It is difficult to manage your emotions when you do not understand how emotions work. Knowledge is power.”

For dates, fees, location and more details, please visit www.lisawessan.com

Onward and Upward,

Lisa Wessan

 

Copyright © by Lisa Wessan 2017. All rights reserved.

 

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Laughter Therapy for Post-Primary Stress Disorder

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One of my favorite sources for excellent international (and national) news coverage is a magazine called THE WEEK.  It is chock full of great executive summaries, plus the editors of THE WEEK have a healthy sense of humor. They express their humor in many ways, such as with their weekly sidebar/column, “Only in America.”  They also have a column for “Good week for/Bad week for” which always gives me a good chuckle, again based on fact checked news stories.

My best laughter therapy from THE WEEK often shows up in The Week Contest, when they ask us to help name something, or label something, or describe something useful to help sort out the news.

The most recent Contest was about creating a new diagnosis for dealing with the current political climate…here are the results, for your therapeutic laughter du jour:

Source: THE WEEK, 10/21/16, page 38:

Last week’s question: The American Psychological Association has found that more than half of Americans identify the 2016 presidential election as a significant source of stress in their lives. Please come up with a psychological term that describes the unique feeling of anxiety induced by this race.

RESULTS:

THE WINNER: “Sufferage”
Phyllis Klein, New York City

SECOND PLACE: “ADHD (Another day with Hillary and Donald)”
Don Walker, Lexington, Mass.

THIRD PLACE: Democrazy
Peg O’Neil, Bloomingdale, N.J.

HONORABLE MENTIONS:

“Strep vote”
Ken Kellam III, Dallas

“Campains”
Valerie Resnick, New York City

“Polliosis”
Dorothy L. Delman, New York City

“POTUS parting depression”
Robert Koshiyama, San Francisco

“Boast rhetoric stress disorder”
Ken Liebman, Williston, Vt.

“Seasonal elective disorder
Emily Aborn, Temple, N.H.

“Pair-annoy-ya”
Richard Pitruzzello, Hanceville, Ala.

“Polls traumatic stress disorder”
Justin Bookey, Santa Monica, Calif.

“Poli-tics”
Curtis Irwin, Clearfield, Pa.

“Turnout burnout”
Peter Bergin, Kings Park, N.Y.

I’m curious, which one is your favorite? Or do you have a better diagnostic term for us to use?

Yes, politics and our election process are serious business, but let’s not get sick from watching this drama unfold!

Onward and Upward,

Lisa Wessan

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Compare and Despair: How free do you want to be?

A few weeks ago I became aware that one of my top-tier, close relatives unfriended me on Facebook…ouch! My first reaction was tightness in my neck and throat, I took a deep breath. Yes, surprisingly, breathing always helps dissolve some of the stress. But then I remembered that she was a teenager, and that it is possible she wanted more privacy in her postings with her friends. I made a choice to believe the best possible reason, and let it go.

This relative is dear to my heart – but I will not ask her, “Why did you unfriend me?” It could only lead to more grief. In the past, when I have asked other relatives “Why?” questions, I was scolded. “Why are you angry?” or “What’s wrong?” can trigger some people who would rather not discuss their feelings. I learned from those times.

The past few weeks, however, when I visited my Facebook page (once or twice during the week), I noticed I had this sad, unresolved grief about being unfriended by this relative. It wasn’t going away, despite my rational emotional response to it.

The good news:

Here is another moment in life when I can actually experience free will – I have a choice: will I let this Facebook event bother me and dwell on it, allowing this teenager to interrupt my thoughts and mental flow, living in my head rent free, causing me to spiral into a possible depression?

Or…will I focus on the strengths of our relationship and trust my first reaction?

I have a history of getting caught up in the toxic realm of negative thinking, which I prefer to call the Compare and Despair syndrome…

What is the Compare and Despair syndrome (“CAD”)? CAD operates on two levels. The first level is when I CAD myself to myself. There is the idealized version of me, and then there is the Lisa du jour; however I happen to be now. How this looks: I tell myself stories about how I could have been better…the classic CAD vernacular is fraught with guilt, self-wounding words and phrases such as I shoulda, woulda and coulda, always, never, and if only. CAD thoughts try to figure out how XYZ could be avoided.. In this case, how to avoid being unfriended on Facebook.

For example, “If only I were more athletic, thinner, richer, my relative wouldn’t have unfriended me…” As if my alleged lack of worth caused this teen to unfriend me. Nay, nay, I say, we don’t go there anymore…

The second level of CAD is when I compare myself to others, which always leads to pain. Practicing CAD with siblings, peers, colleagues and other is always a lose/lose situation; CAD becomes torturous when I read Vogue Magazine or The Week and am triggered by a tsunami of CAD, as I compare my voluptuous body with anorexic models and celebrities. It’s wonderful to read about someone’s success and be inspired – that’s always worthwhile. But to read about someone and feel less than, well, it’s time for some treatment for CAD.

So how can I choose to have a better mental health day? For today, I choose to focus on who loves me, who wants to be with me, who are my real friends, and who does care to connect with me. This is a choice! It’s also a practice –a psychospiritual practice.

From my experience, there is no will power when it comes to transformation. I cannot just make myself think about something – or not think about it — as if I am a programmable robot. No, it takes an army of angels to help me turn around these negative, toxic thoughts. From experience, professional training and years of helping others do this, I have come to understand that we have many kinds of helpers, both fleshly and invisible, who will, for the asking, intervene on our behalf.

Most healthy people by default are non-invasive and non-interfering with our troubles and thoughts. We need to pick up the phone and ask one of them for help. Sometimes this can be accomplished in a five-minute phone call. Sometimes we need to meet with someone for a longer talk, or seek professional help. Whatever, getting better starts with asking for help. Once we roll that stone away, the Universe can move in and fill us with the wisdom, compassion, unconditional love and the connection that we truly crave.

The good news here is that my little relative did a big favor for me. By unfriending me on Facebook, I was able to deconstruct this painful moment and turn it around into a joyful affirmation of my life.

So it’s true: my joy, my love and my experience of life are not dependent on who is my friend, on Facebook or otherwise. Instead of asking, “Why did she unfriend me?” I can ask “How can I be useful today? How can I make a difference? How can I give support, love and creative energy on this planet today?” Yes, asking the “HOW?” question is uplifting and invigorating. Asking “WHY?” just leads to a dip into negative thinking.

I have a few favorite affirmative prayers that can transform Facebook pain into something better. One of my favorites: “I am an irresistible magnet for God’s Goodness, and I attract the right friends, clients, peers and always get what I need.” I repeat this many times, until the soothing effect feels complete. Each time I say it, I am reminded of how much goodness and love IS in my life…and in my big picture, all is well. I am better, not bitter…

There’s also the old saying, “Man’s rejection is God’s protection.” I can choose to believe that this relative and I are really on very different vibrational planes – maybe even different Universes – so why can’t I accept that she is truly not a close friend to begin with? Let’s face it, trace it and erase it, DONE! (This is a great philosophy for people who are dating. I used to say this whenever a romantic situation wasn’t working out well. ) Whenever I am rejected, it is surely for the best, because everything is working towards my highest and best outcome.

Finally, we all end up at the Cosmic Café…at the end of time, at the beginning of time, forever; our souls are connected to each other in the web of life, in the Oneness of the Universe. There is no way to NOT be connected to this delightful little teenager! She and I are already One…why is my pea brain stressing over being unfriended, while our souls are joined together at the Cosmic Café forever? Indeed, whenever I want to connect with her, I can still pick up the phone, text her, or arrange for a visit. It’s all good.

Facebook is a great test for how lightly I am wearing my life. Am I experiencing my life as a loose garment, comfortable and easy, or is it tight, constrictive, punishing and unbearable?

Our greatest achievements do not show up on our résumé, on television or in the media, or in our bank accounts. There are no cash and prizes for these personal victories. Each day is another day of turning a defeat into a victory, a scar into a star, and the feeling is priceless. I can laugh at it and move on, free of any Facebook baggage. How free do you want to be? That is the question.

Copyright © by Lisa Wessan 2011. All rights reserved.

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“There is a crack in everything, that’s how the light gets in.” Leonard Cohen

Leonard Cohen’s quote triggered in me the many ways and opportunities we have to turn ourselves around. Here’s one recent example :

One of my clients was recently going through a tough time…let’s call her Tess. Tess received many financial gifts from her mother — who attached huge cables of control to each gift. Tess had fought with her mother for years about her spending habits, and was in tears about their most recent crisis level.

Her mother had insisted Tess see a specific financial consultant to help her sort out her finances and get more organized with her money. In order to continue receiving financial support from her mother, Tess was forced to share the details of her spending with this man and felt this was a huge violation of her privacy. Her pain was deep, as a 40-year-old woman, she felt humiliated by her mother’s intrusive ways. She felt weak, exhausted, angry, frustrated and depressed from the fights with her mother.

Towards the end of the phone call, Tess said she felt she was falling apart from it all. She feared she was having a complete breakdown from her mother’s brutal words and actions. I was silently listening and saying small phrases of acknowledgment and endorsement while she spoke.

Finally, Tess declared that she would rather be estranged from her mother than keep going through this agony with her over money. At this point, Tess announced she would sell her large condo, move into a smaller place, and become financially independent from her mother. My comment was, “So, you’re not having a breakdown, now you’re having a breakthrough….this may be for your greatest good…what do you think?”

When I said these words, Tess lit up and became so excited…she had revealed her cracking up process to me, and now a little light was coming through the crack. Plus, she was now being empowered by this emotionally depleting situation to realize that for her to have complete freedom — even her own financial freedom — she would need to detach from her mother’s money.

This is what living and practicing conscious transformation is all about, how do we turn our defeats into a victories? How do we use these cracks in our lives for the evolution of our consciousness?
“There is a crack in everything, and that’s how the light gets in,” resonates for me on many levels…So next time, I want to discuss what it means when we are “cracking up…” The good news, the bad news, the view from therapeutic laughter research….yes, more on “cracking up” to be continued….

© 2010 by Lisa Wessan. All rights reserved.

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