Thursday, February 28, 2013

Sleep and Grief

Maybe it should be "lack of sleep and grief".....at least for me. Sleep has sorta been a "frenemy" the last three years. I wanted it, but couldn't get it. Going to bed sounds like an awesome idea when it's 8pm and I am grief-stricken and alone. But then I wake up at 2am and it's not so great.

Pretty much the entire time from the moment of her diagnosis to her final breath, sleep was not very present, certainly not peaceful sleep. Anxiety, stress, worry, all the mental factors impaired it. Then I got on a nasty feedback loop cycle, where I was taking in more caffeine and sugar to get through the long days, but that ends up impairing sleep. The weeks long stints in the hospitals were awful for sleep cycle disruption - critical and urgent care facilities are filled with noise, alarms, and interruptions (not to mention poor quality beds). I went on anti-anxiety and anti-depressant medication when she was initially diagnosed, but over the period reduced them - they helped a bit early on with my sleep, but the efficacy wore off. Same with sleeping pills - initially effective, but the effect wore off.

After Meagan died, I was able to catch up on some sleep, my body and brain just physically exhausted and with some sleep aid medication I did recover somewhat. But unlike in the past (I had never been a long sleeper - usually around 7 hours) I still was only getting 5-5 1/2 hours a night - not enough to keep me mentally fresh and capable of functioning. Lack of sleep is a definite impairment of the grief recovery process.

There is also this weird relationship I had with sleep. In talking to others who have gone through similar experiences I've learned it's fairly common. There you are - however many days or months after you've lost your loved one - and it's evening, you are alone, tired from the days activities, sad, angry, confused, lonely, and the grief fog has you lethargic, unmotivated, and wallowing in self-pity and self-loathing. I'm not into the bar or club scene, and I wanted to be around for my boys when the mood struck them, so going out was not a great option. The only thing that sounds good to avoid all this pain is sleep (especially if you are not into other mood altering or mind-numbing substances - I have been a non-drinker for over 20 years). But it's too early. Then you start watching the clock, is it too early to go to bed yet?

My cut-off used to be 10:00pm. Then 9:30pm. Then 9:00pm. It was such a welcome relief to crawl into bed, and get some sleep, and avoid all that emotional pain and brain chatter.

Until I rolled over and looked at the clock and it was 2:00am. Then 3:00am. Then 4:00am. Then 4:30am. Then I had to have a rule about what time was too early to get out of bed, forcing myself to stay in bed to try to get whatever benefit I could by simply lying there - for my body at least, because the brain was sure working. So then lack of sleep reduces your capacity to function well, which increases the impact of grief and how you are feeling about that aspect of life - so another vicious cycle.

I did a lot of research on sleep hygiene and over the last 15 months have gotten to a sort of truce with sleep. I know the sleep impairment suspects and try to manage those. I get a lot of exercise, and have tried my hand at meditation. Learning to be alone and being ok with that has helped. I've tried to find things to do in the evenings - the witching hours - such as attending classes or grief group support. I get enough sleep now, although I still use a single tylenol pm to help - it seems to work and doesn't have any side effects of note.

But I still have nights where going to bed at 8pm sounds like a really good idea.

Couldda, shouldda, wouldaa....

One of the things that tore me up for quite some time after Meagan's death was the angst over what I could have done, or should have done to prevent the progression of the disease or different decisions about treatment or non-treatment I could have made (after the point she was capable of making them). So post-death I had a lot of grief about the loss of her life and the whole trauma associated the impact on me and my family, but also had this nagging and somewhat inconsolable grief associated with my role in her dying.

I would replay the tape in my head about all the various inflection points where important decisions had to be made, and question whether I had really done enough. Some decisions, such as when to cease treatment of any sort, made in consultation with her oncologist, were obvious on the surface, but because of their import, were highly traumatic. Others weren't as clear. We had been ready to go back to Washington D.C. to the National Cancer Institute for clinical trials when she had her stroke. It eliminated her from those trials. I called around to various cancer centers trying to gain access to possible treatments, only got turned down (once melanoma goes to the brain it is almost always fatal, and therefore you are a poor clinical trial prospect....). But did I call enough places? State the case forcefully enough? Slide her into a program based on compassionate use?

So part of the grieving process for me was about self-doubt and guilt over possible bad decisions or not trying hard enough. Fortunately I had an experience that laid those issues to rest and helped me change my thinking. In March of last year (2012) I went on an 8 day 800 mile cycling trip that did a loop out of Tucson, AZ, run by a tour company. Besides being a way to relaunch my cycling efforts, I thought that a seriously hard effort like this would be meditative and cathartic in some way. For me physical activity, and cycling in particular, has been therapeutic and calming, relieving stress, allowing me to be fully present, and in a tangential way, doing a gut check for how much I can endure.

Along with 26 other guys we took off. When you are riding like this you don't ride all together as I do with my local team or weekend ride groups. You might go off in the morning with a couple guys, then based on pace preferences, spread out. At rest stops and lunch breaks you gather in small groups, and maybe ride off with different people. There is a tendency to connect with certain people based on similar athletic ability and personality and during the course of the riding days you have some conversation. I ended up riding with a couple guys a bit older than me, but similar fitness level, who knew each other.

After the first day riding with them I discovered that one was a brain cancer doctor from Philadelphia, who himself had metastatic melanoma several decades ago, and had been one of the few survivors. Peter was an absolute gem. We had many stretches of riding side by side on long desert roads where we talked about cancer, treatments, and death. He knew a lot of the docs and places I had tried to get Meagan in to see. Unlike anyone else perhaps, he was able to put my mind at ease, and say very explicitly, "you did all you could, you did all anyone could, once it went to her brain it was not a question of if, but when, and you took very good care of her".

What are the odds that on this adventure, I'd meet this guy, and get the right message to help me deal with my grief? Amazing. So I no longer stress or fret about the course of her disease and what happened. Acceptance has brought a measure of relief.

The final irony of the trip, besides meeting Peter, was that we were in pretty desolate riding country out there in SE Arizona. We stayed in some tiny places - not more than a roadside motel and gas station at an intersection of the highways in some cases. One of the last nights was at a point when I was ready to come home, and get on with real life. I'd had the conversations with Peter, felt at ease over that aspect of my grief, but was feeling pretty lonely. These were all pretty hard core riders and there wasn't any socializing in the evenings - it was pretty much wolf down some food at whatever joint was available, then go back to the room to tend your beat up body and take care of your bike and gear. Sitting in the bleak room it dawned on me the irony of the name of the town.

Tombstone.




Wednesday, February 27, 2013

more on grief stupidity

Sometimes the dumb moves turn out for the best, because as I wrestle with the consequences of the decision, and feel the angst or pain or whatever uncomfortable emotion - I end up clarifying what is really important and what my truest, deepest self really needs. It's like the old saying, "good judgment comes from experience and experience comes from bad judgment". So I've made bad judgments, but have learned from them, hopefully without too much collateral damage. People have been remarkably kind and understanding when I have screwed up, and even though I feel bad and guilty, they've had the grace and love to allow me this error and not count it too much against me.

So, an example. Last Fall I was offered a opportunity to go back to work part time. It sounded interesting and appealed to my intellectual ego needs. I thought I could manage the family dynamics well, even considering the upcoming holidays. I had been thinking it was time to look at doing something - I thought I had done enough "soul work" and was ready for a new challenge. Well, I underestimated many things:

how much effort the holidays take, in terms of prepping, coordinating, creating a loving and familiar family holiday experience;
how much the holidays whack you on the side of the head as you realize how much life has changed due to loss, and the resulting difficulty of doing things;
oh right, that time of year coincides with the anniversary of Meagan's death (Nov 21.) and her birthday (Jan. 23) which we wanted to acknowledge with ritual and remembrance;
ohhhh right, I'm in the middle of arranging her burial plot and memorial monument;
and, ohhhhhhh right, what feeds my heart and soul now is very different than before. What seemed important pre-grief now seems not so important to me. What I do needs to sing to my heart and soul. It's not about the competitive challenge or status or achievement. It's about love and helping and support and caring, and being around kind and loving people doing good work (their own soul work or helping others).
ahem.....and I hadn't done quite as much soul work as I thought. An eight day retreat in October cracked me open and let me see how much work was left undone, and how my intellectual self was trying to assert superiority over my emotional and spiritual selves.

So I quit. And felt guilty as hell. Despite the very kind and supportive effort of my employer. It was absolutely the right thing to do, but I still felt guilt. Especially as a guy, when so much of identity - self and as perceived by others - is based on what you do, not who you are.

The passage of time is reducing the guilt, the firm is doing just fine without me. It's allowed me to take the time to really think about what is important in what I "do". Or more specifically, tap into my feelings about what will feed me.


Grief makes you Stupid

I have done dumb things. Across the spectrum of stupidity. Things I had a lot of regret over later. It's an interesting question whether the grief does that or the loneliness. As someone once wrote (I wish I could properly attribute - but grief brain allows me to remember some things and not others), "loneliness will break you".

A lot of the stupidity has to do with not being able to make a decision. It's so easy to be in a state of paralysis where everything seems too much and you flip unopened bills on the desk and forget to deal with them until it becomes a crisis. In the past, I was efficient and dealt with things productively - that was a measure of worth and competence. In the last two years I have left more stuff undone because I just didn't have the will to address them. Lately I have had more energy around small things - like checking insurance rates, and cell phone plans, and telephone line charges, and finding all kinds of opportunities for cost savings. I think how stupid I've been to let this stuff go - what a waste of resources. Yet, I need to be gentle on myself, and think about why it's good now to address it, and what it means for the future, and not beat myself up for past stupidity.

Then there are the stupid decisions, ones taken in haste. I tried to separate out the irrevocable ones from the "no harm, no foul" ones. But in the fog of grief my analytical powers are diminished, and the criteria by which I would usually make a decision strangely absent, and new criteria (untested and unvalidated) show up. Such as, "does this get me out of my pain of loneliness", rather than a more thoughtful, "does this impact my children negatively?".

I'll address new relationships in different set of posts - it opens up a whole new realm of potential stupidity.



The therapeutic value of dogs cannot be overstated. I cannot speak to cats or other pets. But dogs I can.

Meagan's current shrine.  She will be moved to the Lake View Cemetery this Spring.

Tuesday, February 26, 2013

Three Hard Things in Loss

I'm too analytical - working on that. Trying to develop my emotional and spiritual aspects, letting them come out and play more often, and quietly nurturing them. But a while ago (emphasis on AGO) I came up with an analytical framework for understanding what I lost through Meagan's death. And what I was angry about. What made life so hard and difficult now.

First, I (all of us really) lost an amazing woman. Wife and mother, friend and confidant - just gone. A terrible loss. That void is noticed by the universe, her friends and family. Her unique perspective, her joie de vivre is just gone. It's a terrible loss.

Secondly, I lost my partner. Someone who I built a life with, and who was an integral part of my life, who helped shape and mould me. In talking with many who lost a loved one - one of the most profound issues is loneliness. And missing that simplest and most poignant of things - to be held. When you lose your partner, from whatever cause, you are now alone, and that loss of touch and communication and support is gone. It made me angry and sad.

Third, building a new life is hard. Solo parenting is hard. Keeping the house together is hard. Being single in a couples world is hard. Cooking and grocery shopping is hard. Cleaning and organizing and paying bills is hard. Holidays are hard. Navigating new relationships is hard. Focusing is hard. Being alone is super hard. Experiencing new feelings like grief is super duper hard.

You have to have stamina and perseverance, and just keep plodding. Yes, there are moments of gratitude and grace and kindness from others. But there was too much alone time, too many nights wallowing in the pain of loneliness and grief, when I realized that the course of my life, not just Meagan's, was irrevocably altered, and for the time being at least, much, much harder.

Guilt - Part 1

Part of the living with grief process involves living with guilt. I'll write a lot about this I suspect, which is why this particular post is called Part 1, of how many we shall see......could be a lot.

I'll start with the easy guilt, then eventually get into that deep guilt that involves tremendous shame and embarrassment. The easy guilt example for me is around house plants. Yup, house plants. Meagan had a whole interior sunroom devoted to plants. I laughingly called it the plant room. It had seating and furniture, but all sort of useless due to the profusion of plants everywhere (at least for a guy my size, Meagan could curl up pretty small). We struggled to maintain it during her long descent, and by the time Meagan died the plants weren't doing well. When I was in the immediate aftermath of death and soaked in grief, the last thing I wanted to do was take care of plants. Perhaps some would find the tending and care of plants therapeutic. Not me. It was another opportunity to have something die under my watch. I didn't know what they needed, nor wanted to be responsible for watering and feeding and actively promoting their demise through too much or not enough water, light, or nutrients.

So my sister and a friend did some culling. And I moved all the remaining plants but a couple outside - permanently. Not just in fair weather as in the past, but permanently. No hot house plants for me - they needed to make it outside like their outdoor plant cousins. Jungle rules.

I did allow a couple to stay in doors, which I have tended, despite ineptitude. A jade plant Meagan had for 30 years had a near death experience, but it has recovered, and now thrives, yes, inside the solarium (now repurposed as a sun room, with furniture and a human livable setting). As does one of her prized orchids, and some other curious plant (I have no idea what it is), but it seems to bloom continually and I am amused by its persistence, so keep watering it.

So the guilt. Guilty guilty guilty that all her lovely plants that went outdoors have pretty much bit the dust. I toss their husks in the yard recycle bin when I notice they have ceased operations, hoping their remnants wil serve as compost for a future plant tended more carefully by another. Guilty that the plant room meets my needs now as a sunroom, a place to read the paper when the day is nice but too cool to sit outside, or a place to hide when the house is full of young adults or the cleaning lady is vacuuming. Guilt that I'm slowly making this house my house, and even though I know she would be ok with it and want it for me, it still brings me pangs of guilt.

As much as I can write that last sentence, I know that there is one change in the house she would not like, and I'm lying if I write or say she'd be ok with it. It's not about plants - it's about her precious bathroom. The one with costume jewelry and hand painted shower curtain and quotes on the walls and jewel encrusted mirrors and all manner of bright baubles and treasures. It no longer exists, I did not want it to be a shrine, and it did not meet my needs as a guy's bathroom. So it's preserved in pictures only, and those will be bound into a book for kids and grandkids to remember Meagan's unique bathroom - a place of imagination and creativity and a testament to her artistic sensibilities and creative power. I feel guilty about getting rid of it. I don't think she'd approve. Even though I firmly believe she'd aprove of other house changes, such as the changed living room with the combination pool table/ping pong table as a place of socialization and gathering.

So as much as I live with grief, I live with guilt. It's always there too. I try to use it to really litmus test decisions I am contemplating, to make sure as best I can they are rooted in strong principles and things I care about, and not just doing it to make life easy or more convenient. I know some people who still have all their loved one's clothes and personal effects exactly they way they were at death, many months or years later. If that's what they need, that's good enough. If they were to get rid of it too soon, they'd be wracked with guilt. I got no guilt and a lot of pleasure out of giving away most of Meagan's clothes to friends and relatives, and nothing gave me more pleasure than to learn that one of her nieces was wearing Auntie Meagan's cowboy boots on Meagan's birthday.


"Moving On..."

You don't "move on". Or move forward. You move with grief. I think of it as parallel processing. The grief lessens in intensity and domination of your waking moments, although it still ebbs and flows to higher levels during random moments, holidays, and important days. But it is a constant companion. The memory of your loved one is, as another loved one described to me, "etched into your heart", and the grief associated with loss never goes away and you don't move on. If you are fortunate, that grief informs you, changes you in good ways (makes you more loving, empathetic, open, non-judgmental, etc.), helps you learn to sit with your feelings and just experience aliveness in all its forms.


A ritual

Talk therapy is good for me, and good for many guys. It's not for everyone though. Many guys when they are in talk therapy only talk about their actions, not their feelings. Action is important for me too - although I went through a phase where I confused activity with recovery.

One ritual I put in place, which the boys and I practice on important occasions, is a lovely way of remembering Meagan. We have an apple tree in our back yard. On the anniversary of her death, birthday, Mother's Day, and our wedding anniversary - we do several things:  we light a big bonfire and burn greeting cards with handwritten notes (the smoke from the burning sentiment sending our loving thoughts to the universe), and then each hang a small wind chime on the apple tree. The tree is starting to get quite a few wind chimes, and when the weather is nice and the breeze is blowing, the sound of tinkling chimes fills the backyard. And that sound helps trigger warm memories of her, and brings a smile to our faces.

As an act of love and remembrance it is also highly therapeutic. In the face of a profound loss over which we had no control, the ability to act to create a memory, especially one she would appreciate as she so loved her garden and yard, is quite calming and helpful.

Ritual

The healing power of ritual, as demonstrated by my friend Dennis Evans

Sent from my Windows 8 Phone

Needs in time of grief

I attend grief support group regularly at The Healing Center. The primary benefit is being able to sit in a circle for an hour and a half with people who have been through a loss experience (loss of a loved one) and do two simple things - tell your story, and listen to theirs. It's not therapy - for that I see a therapist. For me, the value of being around people who have suffered a similar loss is huge - because they get it in a way others don't. They understand the depth of pain, the loneliness, the brain fog, the despair, the inability to function, the missing of touch, the loss of shared moments, and the challenges of building life anew.

Each person's story is different, and the process each is going through unique. But there are always points of commonality, and the opportunity to bear silent witness to the other person's struggle is a gift. My own healing progresses when I get out of my own head and am empathetic to others, and learn practical things about how they are coping or simply hearing about their struggle makes my own somehow more bearable.

Everyone has different economic circumstances and worries, family and friend support structures, and personalities and coping and functional skills. The Healing Center does provide an avenue for emotional support and a community of kind, caring, like-minded individuals. But what doesn't exist is a place someone in profound loss can go to navigate the challenges of life without your loved one - advice, counsel, and direction for overall wellness, nutrition, exercise, stress reduction, parenting help, financial planning, care and comfort, meals and household help (cleaning, organizing), gardening, etc. What seemed doable when you had a life partner seems daunting and impossible when you are alone and in grief. Many faith traditions provide a community of support and care teams to help those who are members of that community, but when you are not a part of such a community where do you go for help?

What I've learned is that what seems like an easy task to someone on the outside - such as cleaning your home - can be a huge challenge to someone in the throes of grief, enough to send them to the floor in despair.

Monday, February 25, 2013

The Fog of Grief

I've read a lot about grief, aside from experiencing it. Talked a lot about it with therapists and group support. Heard different perpectives and personal stories. Couple thoughts.....one, it is a unique experience, no one person has the same process, and it doesn't follow predictable pathways or timeframes. Two, everyone seems to move along a continuum, through readily definable stages (more on this later). But it's not a linear process, you move back and forth along the continuum and I would argue, you can be a different points on the continuum at the same time, defying the laws of physics.....

For example, I might be doing just fine on the surface, feeling good about life and the future, and having warm memories of life in the past. Then, wham, I'll get hit with a flashback, usually around a traumatic event associated with Meagan's disease, like the stroke episode. It will generate a very visceral response, trigger all sorts of other memories, and in a series of cascading memories, send me into a very sad, depressed, and anxiety ridden state.

When you are in that state it is hard to think and hard to do anything. It's called the fog of grief. I become kinda paralyzed. Easy stuff seems hard. Procrastination rules. Energy to do anything significant is just not there. Then I start feeling guilty about that, because I remember what it was like to be efficient, productive, and proactive. It sets up a negative cycle.

One of the sayings at the Healing Center is, "be gentle with yourself". It's a good motto, and one I think about a lot. It's not an excuse, just a perspective. Time is a gentle healer, and forcing things does not help. Sometimes you just need to sit with your grief or sadness, and reflect.

Sunday, February 24, 2013

Meagan Memorial

I went on an 8 day retreat last Fall that was all about grief, loss, recovery, and learning tools and skills to help cope. One of the conclusions I came to was that I wanted a special place to remember and honor Meagan. Although I have a special place for her cremated remains in our home, it does not work as a safe, contained space where one can grieve. Cemeteries serve that purpose well, and after lots of looking and thinking I secured a lovely cremation burial plot at Lake View Cemetery on Capitol Hill here in Seattle. It looks east, with views of the Cascades, Mt. Baker, and our home in Laurelhurst.

But how to mark the spot? Fortunately I came across an artist and designer of monuments who works in fused glass. We have come up with a fantastic design for a monument which is unique and quite fitting for Meagan. It won't be finished until probably around May. I'l have it installed, then a simple ceremony to inter her ashes at the site. I'll definitely let everyone know when it's complete, and will do a party to celebrate. But I'll not provide any directions to the actual location of the burial plot. The monument itself will be quite distinctive and anyone going to the cemetery will be able to find it quite easily if they know anything at all about Meagan.

I'll write more later about the importance of ritual in my grief process. Especially for guys, physical acts are important. I do grief support and group therapy. But it's not for every guy. I'm looking forward to the ritual of visiting her gravesite, and remembering her, honoring her, and grieving.

Inaugural post

I'm starting several efforts, one of which is to write about grief from a guy's perspective. I've learned a lot, including getting a ton of support from this organization here in Seattle:

http://www.healingcenterseattle.org/

It is a place of recovery, with kind and empathetic people. One of the things they do is provide support groups, in the evenings, where you gather with people who have gone through loss of a loved one, and share your experiences and feelings. I'll write more about this in the future, but for now, the healing power of sharing your story and being a silent witness to others is quite profound.