Tag Archives: stress

Coping with Unexpected and Sudden Loss

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Coping with Unexpected and Sudden Loss

Arlene K Unger, PhD

We all know that life is finite but when a death comes suddenly it can throw us into traumatic grief and shake up our world. No one is exempt from loss, death, or grief but when it comes suddenly, we can “free fall” into a chasm of despair, as noted by clinical psychologist Glenda Dickonson, one of the leading commentators on grief. This despair can keep us trapped in a state of numbness, confusion, and disbelief for weeks.

When we become fixated on the loss it makes our bereavement complicated and embedded in our minds as catastrophic. This often occurs when we refuse to talk about the person we lost or end up dwelling on the why, what really happened, and will it happen to us or someone else we know. This can make the process of letting go or moving on much more difficult and painful.

It is important to differentiate our loss (grief) from our fear (trauma). When we add fear to our grief, we inadvertently become victims of trauma as well as loss. This leaves us feeling powerless which may result in feeling sensations of physical pain, insomnia, irrational fears, and emotional paralysis. A Post Trauma Stress Response to grief may reveal itself in a lack of appetite, motivation, and focus. The above symptoms mirror depression and if not properly addressed may lead to a more serious situational depression.

If you have lost someone and cannot tell if you are experiencing catastrophic/traumatic grief, here are list of additional symptoms:

  • Preoccupation with idea of death
  • Sympathetic physical pain (which the deceased may have experienced)
  • Memories that trigger the trauma
  • Loss of hope and longing for the deceased to be here
  • Ideation and feeling like life is just not worth living
  • Chronic loneliness
  • Being overwhelmed, stunned, or dazed
  • Jealousy and envy
  • Anger and disbelief
  • Longing for the person
  • “Hearing” the voice of the person who died or “seeing” the person
  • Being drawn to places, activities or objects associated with the deceased
  • Experiencing disbelief or anger about the death
  • Thinking it is unfair to live when this person died
  • Being envious of others
  • Having difficulty caring about or trusting others or even yourself

Grief comes in all shapes and sizes; everyone grieves in their own way. This is because we have different attachment styles, experiences, coping mechanisms, and ways of thinking about the trauma.

LETTING GO

Whether or not our loss was anticipated, natural or shocking, we need to learn to process it before letting it go. Talking about the deceased, journaling remembrances, writing mock letters, finding positive visualization, or using the creative arts to process our pain such as creating playlists have all been found effective.

The process model of grief recovery aims to eradicate our shame, reduce our emotional overload, and reboot our limbic system. When these do-it-yourself techniques do not restore our faith or relieve our guilt, finding the right therapist can have a huge positive impact. They know how to provide just the right amount of silence, validation, and meaning to what you might be feeling. When it comes to finding an expert to process your traumatic grief (as well as past associated traumatic events) EMDR (Eye Movement Desensitization Response) therapists are the most effective. They can foster both the healing and closure processes.

Everyone attaches a different meaning to death. When we are dealing with traumatic loss, we tend to add our negative beliefs to grief making us feel much worse and guilty for the loss. We fall into a preverbal “grief hole.” An astute grief counselor can help us out of that hole by detangling our negative thoughts and gradually replacing them with more positive realizations and expectations.

Neuropsychologists have found that our brains naturally want to consolidate our fragmented and upsetting material, integrate this with our immediate reality and plan what happens next. Trained grief counselors can help us learn to be kinder to ourselves, refocus on our needs and the needs of our remaining loved ones. This helps us create new meaning and take steps to slowly move forward. This does not mean we are not sad about our tragic loss; it just gives us the energy to preserve our sense of self with more gratitude in our hearts.

If you think you are dealing with sudden and traumatic grief:

  • Find your patience, know that grief has no set timeframe and there is no one right way to grieve
  • Embrace kindness and be gentle with yourself
  • Allow your feelings of sadness, anger and even joy to show and try not to fear any feelings that come up
  • Permit yourself to revisit what happened and replay the experience
  • Be creative with ways you can express yourself including pain, loss, and relief
  • Remember that grief is an active part of loving and it takes courage to grieve
  • Keep a daily routine and structure
  • Get help if PTSD symptoms do not remit or only fade gradually

References

Coelho, Stephen “What is Traumatic Grief.” Psych Central, 2022.

Phillips, Lindsey “Untangling Trauma & Grief After Loss.” 2021.

Lim, Jamie “How to Grieve a Traumatic and Violent Death.” 2020.

Resources

Arlene K. Unger, PhD is a Telehealth Psychologist in Private Practice in Dana Point. She has been a contracted staff provider with Mission Hospital/SCMC since 2005. Arlene serves on the Mission Hospital Medical Staff Wellbeing Committee. Her other articles, blogs, and books about Mindfulness can be found on her website: www.drarleneunger.com.

POST-HOLIDAY BLUES

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Post-Holiday Blues is not a myth. It is the feeling of letdown and anticlimax after the excitement of big celebrations coming from all the hope and energy that we put into them versus all the potential disappointments that we get out. We may feel this even more if we feel we frittered away precious time that we cannot get back.

There is an implied “rule” or norm about having to be happy as we celebrate the holidays. We are supposed to be joyous and optimistic, but this is not always the case for everyone. In fact, we may feel blah about the year that just past or the upcoming new year, especially now with all the potential uncertainties around the pandemic, economy, climate, and so forth.

Nonetheless we put on a happy face when asked “How was your Holiday?” The truth is that so many have had to forgo plans with friends and family this year due to COVID, travel costs and interruptions, weather, or just mental fatigue. Gatherings, especially during these unprecedented times can leave us bewildered, sad, anxious, disappointed, and lonely. Much of this has to do with the unrealistic demands we, or others, place on ourselves. If we buy into these false expectations, it will only deepen feelings of isolation, not measuring up, and even depression.

To cope better with the Post-Holiday Blues, we need to harness our isolation, manage our obligations, and adapt. The strategies below may help:

  • Accept that we are all different and the world is different as time goes by. If we went to a large public celebration one year, we embrace playing scrabble with a friend next year. Rather than over commit, tell yourself this new year is time to do a little less, and self-soothe more.
  • There is nothing like walking off a meal. With holiday overeating it may be a must. Rather than create unwanted pressures, just set little reminders on your phone to breathe slowly, stretch and go out for a walk. When obligations, or the lack thereof, become too much, just walk them off. Remember the more sunlight and fresh air we get, the more we will attract positive thinking and healthy problem solving.
  • It is easy to bemoan the conflict between what we wished we could have done and what we actually did. Rather than fret over missed opportunities, make this new year about trying new things that make life more interesting and special.
  • Throw out your old ideas that everything must be just one particular way. Be flexible and accept that change is normal. You might try a new herbal tea or international cuisine, change up your daily home routine, go to some outdoor venue you’ve never visited before, listen to a different style of music, read a different type of book, take an online course … Change does not always need to involve money, or more time; you can change almost anything, and it can help lift you out of that blah feeling.
  • The real crux of Post-Holiday Blues is the lack of connection. This may sound strange, but to stay connected you must be able to take emotional risks. This means being a little vulnerable but telling those you trust the truth about how you really feel and what you really need. A hug goes a long way, and you might find out that sharing will lead to you feeling unburdened and them to caring more.
  • Too many of us agonize about reaching out to out-of-contact family or friends. They may need some support now too, so why not just try it?
  • Be honest when someone asks you about post-holiday plans or resolutions. Most people won’t judge and are in the same boat. Sharing your goals with a friend can help you both to come to the best solutions and reinforce your desire to stay on track.
  • Don’t have much going on in the new year? think again. Instead of bemoaning the fact that you have nowhere to go, see where you can lend a hand by volunteering. Your community may have ways for you to get involved It is a matter of reaching out and allowing yourself to give what you want to get.
  • Look for the good deeds and overlook the roadblocks. It is so true that holding grudges is not only bad for your health but attracts more stress down the road.

The best protection against Post-Holiday Blues is self-care. Manage all that food consumption with an appropriate get-fit routine, get enough sleep, try new things, reach out to others, and have a positive attitude. We can always get through any stressful event if we just keep up with a healthy lifestyle. Not only is it good for your mind and body, but it is also a great distraction from everyday worries.

REFERENCES:

Everyday Positive Thinking (Louise Hay).

In A Holidaze (Christina Lauren)

Wintering “The Power of Rest and Retreat in Difficult Times. (Katherine May)

When Holidays Hurt (Bo Stern)

ABOUT::

Arlene K. Unger, PhD is a seasoned Telehealth Psychologist in Dana Point, California. She can be found on numerous mental health platforms and accepts most insurances. In addition, she has authored 7 books on positive visualization and mindfulness. Arlene was past president of Orange County Psychological Association in 2012 and has continued to serve as a Clinical Affiliate of the Executive Well-Being Committee at Mission Hospital since 2014. Her many other blogs and articles can be found on her website http://www.drarleneunger.com.

Dealing with COVID Cabin Fever

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Dealing with COVID Cabin Fever

If you find yourself being forgetful, easily irritated with people around you, unable to get to bed or get out of bed, feeling bored or helpless, walking around in daze, or having sudden food cravings shortly after a meal, you might be dealing with the negative effects of being quarantined.

“Cabin fever” is usually associated with a type of claustrophobia and S.A.D. (Seasonal Affective Disorder). It is a term especially used during the winter months when it’s cold, the sun rarely shines, and we can’t easily get outside. Most of us can deal with cabin fever especially when we know there is a predictable end in sight. Unfortunately, with COVID-19 authorities don’t know a specific end to our new “Shelter in Place” lifestyle. A lot depends on the population following prevention and isolation measures.

Some say it can get worse and, like in Italy, people may only be allowed out for very limited purposes and might even be given a fine for violations. Being chronically away from our usual activities, friends, family, and co-workers seems to worsen that feeling of being cooped up.

The Stresses of Isolation

During this pandemic, where social (i.e. physical) distancing is the rule, almost everywhere, the stress of isolation brings with it some personal problems. Among them are loneliness, fatigue, motivational problems, hopelessness, unwanted weight gain, anxiety, depression, mental inflexibility, apathy, inadequate nutrition, lack of fresh air, sunshine and exercise. These symptoms may show up in clusters or one at time and there is no uniformity to them between people (just like the symptoms of a COVID-19 infection).

With more people out of work, or working from home, and with school and entertainment venues closed, isolation can certainly set in, making our ability to get through quarantining even more difficult.

Coping Skills

If you notice that you have some of the above symptoms and they seem severe, it is best to reach out for help right away. We are fortunate that there are MDs, therapists, lifestyle coaches and others available online to support you during this turbulent time.
If, though, you see only a few of these symptoms and they are mild, there are things you can do now to make your situation at home better. Here are some coping skills to manage the result of being stuck at home:

  • Bed is for bedtime: Sleeping longer at night, taking longer than needed naps and hiding out in bed will add to your sense of helplessness, as will working in bed during the day. Force yourself to get up and dressed on schedule and act like you are ready to go somewhere important even if it’s just on a brief walk.
  • Put yourself on a schedule: Establish a daily routine; it is especially good if you are restless or don’t know what to do next.
  • Convert hopelessness into helpfulness: There is someone out there that you can call on and let them know that “I am here for you and want to help.” For instance, the blood supply is low now so if you are healthy think of donating blood.
  • Get a Natural High: Open the curtains, or door or take a walk outside. The combination of vitamin D, fresh air and exercise does a lot to help pep you up.
  • Limit your sugar and high fatty food intake: Start monitoring what you eat. Try to manage the tendency to overindulge by prepping your meals and eating at regular times at a table rather than in front of the TV, phone or iPad. Adjust your food intake if your activity level is lower than normal.
  • Reward yourself: This is a great time to set achievable goals, track your progress and celebrate your successes. When you make of point of completing things you set out to do, you are climbing that wonderful ladder of self-esteem.
  • Be your hobby: What better time to (re)find a craft, hobby or skill. This will help you feel less boxed-in and give you a sense of accomplishment.
  • Be active indoors: Especially when the weather is not the greatest, try embracing indoor exercise. There are many free workout videos being offered online. Kids love to participate, and it helps burn off excess energy.
  • Learn new skills: Turn off the news, your social media and sitcom reruns. Here is your opportunity to learn something new and challenge yourself. The internet is a treasure trove of learning material.
  • Reach Out: If you can’t be near your loved ones, call/text/Skype/Facebook to find out how they are doing. You will both feel better!
  • Remember to celebrate milestones: Even if you must Skype or Facetime with family and friends, don’t forget to celebrate milestones like birthdays, anniversaries, etc. Plan a theme. When we get our brain cells going, the four walls won’t feel like they are closing in on us.
    • See my Blog “Coping with COVID-19” and other Blogs on practical mindfulness, as well as my resources page.

Be positive! Problems can also be opportunities! Consider that, however bad it may get, metaphorically, this is the world’s method of resetting itself. We will have cleaner air and water, less traffic accidents, more time to develop new skills, and more to time enjoy our loved ones. Now let us try to reset our own personal priorities and habits. This means putting more effort into our own health and interactions with the people we live with and love. Mankind has survived many pandemics and other calamities in the past and we will do so again.

We are all in this together and can all do our part to make this a better world.

Arlene Unger, PhD is a Dana Point CA based Clinical Psychologist in private practice. Her approach is using Cognitive Behavioral Therapy along with Mindfulness an Acceptance Commitment Therapy. She is the author of numerous articles (www.drarleneunger.com) on the practical application of mindfulness.

She now concentrates her practice on Telehealth. She works with numerous platforms including Telemynde, Betterhelp and Talkspace and accepts most forms of insurance. Dr Unger has 20 years’ experience with Telehealth as an early adopter and has lectured on the topic.

Adopting A Restful Mind This Holiday Season

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Adopting A Restful Mind This Holiday Season

As soon as the days get shorter and the air crisper our mind sirens seem to set off, especially around bedtime. Thoughts of family obligations, shopping lists, work deadlines, and even the upcoming tax season start to flood in. What happened to the sugar plum fairies, candy canes or candle ceremonies of our youth? So how do we bring holiday cheer into our thoughts while leaving the reindeer stampede outside?

ACCEPT REST

Training your mind to rest takes daily practice; it’s not an automatic skill. We have inadvertently trained ourselves to be super alert during wakeful hours, but that alertness doesn’t suddenly shut off at bedtime. Some of that may relate to not making time in our day to pause and reflect. The key is to leave problem solving to certain times each day and not just when we are settling down.

Sleep Train Your Mind

We need to train our over alert minds to take power naps, or time out, breaks during the day so at night we can easily fall asleep. Tossing and turning at night is typically the result of an overactive mind that can’t settle down. The key here is to make your bedroom your resting place, so when you enter this space, you will trigger restful thoughts. Soft music, dim lights and shutting down any of your blue light activities at least one hour before bedtime can give your mind the rest it deserves.

Worry Free Nights

At least two hours before bedtime—and outside the bedroom–set out to address any unfinished business that you didn’t address during the day. Personally, I like the idea of writing down my concerns for the day in one column and my hopeful solutions besides them. If I can’t come up with a solution, I write down “let it go for now.” Just jotting these concerns and answers down frees my mind to relax, rather than carry my worries into my sleep.

OCCUPY YOUR MIND

Reading about fiction at least 2 hours before bedtime, can give your mind the transition it needs from being overwhelmed by personal problems. Sometimes just trying to imagine the characters dress or customs refocuses and deactivate our minds. Also, imagining relaxing hobbies can be another tool to quiet your brain from overexerting itself before bedtime.

Manage “Poor Sport” Sleeping

One of the worst things you can do to screw up your sleep pattern is filling your mind with the belief that you’ll never get to sleep or stay asleep. Similarly, forcing yourself to sleep is just as bad for your mind and body. Try changing your beliefs and expectations about sleep. If you are beating yourself up, sleep won’t come easy no matter how much you try.

Be Mindful

Future thinking can evoke worry so why don’t you focus on the present when it’s bedtime? I like asking myself “What do I hear, sense, or feel as I am breathing? When something comes to mind, I just notice it and let it go. I try not to get caught up or trapped in my thoughts. Remember being mindful takes practice but you can learn to observe your thoughts even when you are distracted by the “have tos” of the next day.

PRACTICE SOS

Why not wake up from a restful sleep with gratitude and the determination to practice SOS (Slow down, Open Up and Smile). There is nothing like starting the day calm and centered. As you open the curtains, commit to being open to possibilities as well as problem today. While looking at yourself in the mirror tell yourself that it is okay to smile. By repeating this ritual daily, your rested mind will be ready for anything that comes your way.

 

REFERENCES

https://www.sleepfoundation.org

https://www.mayoclinic.org