“Grief.” Image by bogenfreund via Flickr
Dr. Patricia Yarberry Allen is a collaborative physician. Her patients, she believes, will be her best partners in providing diagnostic information—as long as they are asked the right questions. She also believes in consulting with the best medical minds on issues that require specialization or unique clinical experience. This week, Dr. Pat asks WVFC’s “resident psychologist,” Cecilia M. Ford, Ph. D., for counsel on how to comfort a friend who is enduring the first major holiday after her spouse’s death. Dr. Ford has been a psychologist in private practice in New York City since 1987; her current areas of focus are chronic illness and depression, eating disorders and body image disorders, sexuality and relationships, and parenthood and careers.
Dear Dr. Pat:
I am concerned about my friend who lost her husband a few months ago. She is a 50-year-old attorney and had a wonderful marriage. Her husband died suddenly, apparently from a heart attack while riding his bike for exercise. They had married in their early forties, had no children, and did everything together, although both had many loving friends separately and together.
They always gave the Christmas Eve party for 50 people with a beautiful tree, a thoughtful small gift for every guest, and a wonderful buffet. The people who attended were as close as family could ever be to this couple.
Now we are wondering how to include Mary in this season. She goes to work every day, goes to the gym, and generally looks thin and sad but healthy and pulled together. Each member of our group of 12 women who have been in Mary’s inner circle has reached out to her, but she has quietly but firmly told us that she “can’t see anyone outside work right now.”
What would you suggest to us as we struggle to know when to call, email, or contact her? Is it a bad thing to send her our “Merry Christmas” card with family photos of a joyful year? We don’t think she is seeing a therapist. She never had before. What advice would you give Mary if she were to read this question?
Betty
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Dr. Ford Responds:
Dear Betty:
Your friend Mary is still in a stage of deep mourning, and the holiday season, which she and her late husband celebrated so exuberantly, will be painful for her. The situation you describe is particularly challenging for her close friends, since she has made it so clear that she wants to be alone. Though she may indeed be grieving so deeply that she may be unable to muster the energy for social interactions, you and her other close friends must make it clear that you wish to see her on whatever terms she wishes, and be as persistent as you dare.
Based on my experience with patients I have worked with over the years, as well as my own personal losses, I would recommend the following steps to help Mary (and others suffering the loss of loved ones):
• Do NOT avoid sending the usual cards and invitations. She knows you and others still have loving families, and it feels terrible to be treated as if she is now “weird” in some way. This is not a good year to send her fewer Christmas cards or to leave her out of things! I would, however, add a very personal note with your card. Do not avoid mentioning the deceased. Again, please know he is on her mind all the time anyway, and to not mention him is a glaring omission.
• Though I would invite her to your usual party, I suggest that you also suggest an alternate activity, either for the two of you or for a smaller group, especially for Christmas Eve. At the very least, I would check with her relatives to make sure her plans are solid. Despite what she says, it is not a good idea for her to be alone. Remember, she won’t have work to distract her.
• Make sure she knows that the usual boundaries DO NOT apply. In other words, if she does accept an invitation, or agrees to let you drop by, let her know that she can slip away into the bedroom, or the two of you can sit and watch TV all night if that’s what she needs.
• Be specific. Almost everyone says, genuinely, “Let me know if there’s anything I can do,” but people very rarely will be able to respond to that. However, if you mention specifically something you think you can do to help (“I’ll be happy to dog-sit any weekend you need to get away”)—or, better still, go ahead and do things for her. In times past, communities organized to aid grieving families by setting up schedules to make sure food and child care were always provided. In today’s larger and more secular cities, that has fallen by the wayside beyond the immediate weeks of mourning.
But mourning can go on for months, and usually lasts at least a year, with each holiday, birthday, and anniversary presenting a fresh hail of arrows.
Give her something to look forward to. Make a suggestion, again somewhat specific, that the two of you do something special or healing after the holidays, something that in the past this person might have really enjoyed, such as a massage, or, if you can afford it, a spa day or weekend. Mourning and depression often involve the inability to enjoy normal activities, and so she may well say no, but planting the idea might not be a bad idea. Again, just going ahead and booking it is a possibility: some people do need to be pushed.
Mourning can become pathological and can settle into clinical depression—in which case, therapy may be indicated. For Mary, it’s too early to say, though I am worried that she is availing herself of no social support. The loss of a life partner can be among the most devastating because he was involved in every aspect of life and is missed at almost every moment. (Perhaps that’s why work is still tolerable—he wasn’t with her there, at least.)
Finally, if Mary were reading this question herself, I would advise her to push herself to spend time with those she feels most comfortable with, to reach out if she can, especially to those who are real friends (who know this is not about them). Also, I would suggest she try to find others who know what she’s going through—many people say “I know what you’re going through,” but unless you’ve been through it, actually, you don’t. There’s a great comfort in speaking with those who know how it feels to want to share something, and then remember once again that he’s not there anymore.
Dr. Cecilia Ford
"My hour of morning light has been moved to the evening for people who want to walk or bicycle in the evening light. I wish these people would just go to the gym or do a Jane Fonda workout video indoors and leave my morning hour of sleep alone."
Dr. Pat Allen and Dr. Joseph Safdieh counsel a woman who is desperate for relief from severe menopausal symptoms, but has been advised not to take hormone therapy because she suffers from frequent migraines.
Several recent studies have shown the positive benefits of physical activity (from regular exercise to household chores) in possibly reducing the risk of Alzheimer’s and mental decline, even in people older than age 80.
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I’m so sorry for your loss, Joan. I agree with your suggestions for Mary’s first Christmas alone. Never able to have children, my husband and I were madly in love. Our lives were entwined. When John died suddenly at the age of fifty-four, grief overwhelmed me. The support of my sister and a few close friends helped me face my first Christmas alone. They supported me in many ways:
1.My sister helped me decorate a small tree with ornaments John and I had collected over the years, and shared stories of John throughout the evening.
2. I spent Christmas with her family and participated at whatever level I could. If I needed to retreat to the bedroom to cry, she covered me with a blanket and let me rest. At dinner she encouraged me to eat and after packaged up mini-meals for me to take home.
3. During the months that followed, she sent cards of support and called frequently to see how my job was going. Hearing her voice filled some of the emptiness at the end of my day.
4. Even though she often felt helpless, she stuck with me.
I found, a few strong supporters made a huge difference. I knew they understood and I felt comfortable calling them to go for a walk, a movie or a last minute get together. I feel respecting what the grieving person wants and needs is important and at the same time continuing to stay connected is critical. The need for support continues beyond that first year. For me and other widows I’ve met, the second year was sometimes more difficult than the first.
It’s been twelve years since my husband died. I still think of him everyday. The tears flow less often, the grief has softened, but will always be a part of me. In 2011, I released my memoir, Twenty-Eight Snow Angels: A Widow’s Story of Love, Loss and Renewal, about rebuilding my life after John’s death. (http://outskirtspress.com/snowangels) The book’s getting wonderful reader response, is helping others find meaning in life again after the loss of a loved one and for that I am grateful.
Thank you, Joan, for sharing your insights and congratulations on that book. I know our husbands are smiling down on us!
This is a beautifully written answer to a tough question. In my first holiday season after losing my husband to cancer, I was distraught and in profound grief. I hated the holidays — because my Robert had loved them, and because his birthday was about that time, too.
My loved ones helped me in these ways:
1. Invited me to gatherings, and when I said no, they told me I didn’t have to let them know if I was coming, I could just show up or not. On Christmas Day, I decided at the last moment that I did want to be with these people, and I went, and it was warm and wonderful. I would not have gone if I had to commit earlier.
2. Encouraged me to talk about Robert, didn’t avoid the subject (which some people weirdly did). I loved it when they shared their stories and memories of him.
3. Helped me make new memories on important dates. This was a suggestion from a grief counselor, and it helped me greatly: On a special holiday or anniversary, do one thing that honors Robert’s memory, and do one thing that you’ve never done before to start making new memories for this date.
One more tip: as the years go by, don’t assume that your friend is done with grieving. Many of us never finish grieving — the knife in our heart just sinks less deep as time goes by.
I’m approaching my 5th Christmas without Robert, and I’m crying as I write this. There is joy and fulfillment in my life — I’ve written an award-winning book since Robert died, and I laugh many times a day. But the hole in my heart opens up easily still.
Thank you for this post and the opportunity to share my experience.