In Sane Grief

...in Meghan O'Rourke's Slate series on the death of her mother and its effect on her life is this one entitled Finding a Metaphor for Your Loss. Like a somewhat more literary version of women's magazines self-"help" quizzes, the essay prompted me to think about how I "visualize" my mother, now that she's gone.
    I have what I call an analogy for what happened to her when she died (what happens to all of us when we die) and my thoughts about the chasm between the dead and the living. I formed this analogy a few years ago and my mother's death didn't change it. It doesn't, though, explain my imaginings when I consider whether my mother, or something of her, remains here, more than in my thoughts (an explanation which I, too, like O'Rourke, find tiresome).
    Unlike O'Rourke and her friend (cited in the article), I haven't placed my mother in anything so concrete as the wind and the water. For awhile I thoughtlessly assumed that I identified her with this house, then, more specifically with the living room, which became the heart of our house and home during her life. When I began serious work on the yard after her death, though, one of the hardest aspects of being "out there" was that my habit of keeping my being trained on the house during her life when I was out in the yard was not only no longer necessary after her death, it made me feel her loss all the more because, well, each time I automonically listened to our home I confronted her absence, which was, depending on the day, anything from mildly depressing to paralyzing.
    Soon after reading O'Rourke's essay I began to observe sightings of units of existence, you know, animals, states of weather, that brought my mother to mind. Crows, for instance. We have a noisy, prominent population of large black crows in this area in which both my mother and I delighted. When she was awkae and I heard crows cawing around our home I'd rally us outside to check out their activities. During the last few years of her life, when she was no longer interested in literally venturing outside but continued to imagine herself going and being outside, I'd spot them through one of our many windows and maneuver her, with her walker or in her wheelchair, to a prime observation post. I don't, though, I noticed a month or so ago, imagine that she is a crow, or even with the crows (which she may be, you never know).
    The same situation occurred when our first herd of spring deer meandered into our front lawn this year snuffling for tender shoots. When Mom was alive, observing the deer was such a treasured activity that I'd awaken her for an appearance (unlike for the crows). But, I've also noticed, I don't imagine that she is visiting me as one (or more) of the deer.
    A few days ago when I was indulging in some late day, early spring baking (best to get it in before the weather turns warm and the heat of the oven, even in the deep evening, becomes irritating), I noticed that I am, indeed, imagining my mother here, with me, just below my conscious awareness, most of the time, but with me. I imagine her, in her rocker, immense, shot through with thought-form but without substance, behind me and a bit to the right of my right shoulder. Sometimes I imagine she is attending to me. I haven't talked to her much, yet, so her attention is on what I'm doing, not on what I might say to her. Sometimes she is simply there, here, continuing to experience the world as part of the her-and-me team that had its beginnings long before we became companions. At times she's thinking her own thoughts and I'm wondering about the direction in which those are wandering. At others it seems that she and I are thinking in tandem and she's adding her considerations to mine. Sometimes I believe she is observing me...and wondering...
    When I am aware of her, I notice that I experience myself immense and gauzy, too, so neither of us is dwarfing the other, although I tend to think of her as extending "above" me, "beyond" me to the right...as though she has achieved a state that lies implicit but not yet possible within me.
    As I've mentioned in previous posts, I also imagine her as cavorting with relatives and friends who share her state...but, when I imagine her with them that is different than imagining her with me. Not that I consider her absent from her over-my-right-shoulder perch when thinking about her with those who died before her and who waited for her, probably without a lot of patience, knowing her relatives, but with ardent hopes that she would "keep at it" as long as she could. I imagine them saying to her, under cover of dreams and her timeless states when she was alive, "No hurry, dear, yes, we're anxious to be with you, again, but you'll get here, don't rush it." Her family believed in the life long and well lived...even those who lived neither long nor well believed in it.
    The more I think about my post-death considerations of her, the more aware I become of times, when she was alive, that I imagined her with me in much the same way, when I was running errands while she slept. Or, perhaps it was that I was concentratedly with her; staying tuned, knowing (which often happened) that my ulterior State of Alert, focused in her direction, would signal me if she was rousing and I needed to put aside this or that errand for another one of her sleep periods and hurry home.
    So, nothing, and everything, has changed with her death. I cannot be with her in any way that makes sense to me, rather like an unborn child who is of her mother but doesn't know of her mother. It's incredibly frustrating, since I know of death in a way that unborn children likely don't know about birth, but I continue to imagine her with me...with a state of me, that state that floats like a baby in the womb of post-birth life, having no idea what awaits me once I burst through this physical state but knowing that, whatever else awaits, I will, again, be able to experience being in touch with her in some unknown way because we will have, finally, shared the fate of all the living.

Labels: Afterlife Metaphors, Death Analogies, Slate

    Despite my amusement with the concept behind the Texas Revised Inventory of Grief [TRIG] I am, at heart, a product (sometimes a proud product) of my industrial-civilized upbringing and usually can't pass up the opportunity to take a self-"help" test, which is one of the possible uses of this particular grief assessment. I'm not alone in this. Meghan O'Rourke, whose series of articles about grief in Slate brought my attention to the TRIG (she mentions it and provides the same link to it I've posted above, in the ninth paragraph of the third article in her series, which is linked to the above reference to Slate) also found the assessment intriguing enough to "take".
    Punching the name of the assessment into Google unrolls a list of 27,200 references. If you surround the phrase with quotation marks, the list narrows to 1,310. This, I think, speaks on behalf of the popularity of the assessment, if not its reliability. Most sources advise professionals to use the assessment with circumspection. There has been at least one adaptation of the assessment with an eye to grief involving the loss of a child. This assessment is interesting because it rewords the statements to apply to losing a child and adds a third section, entitled "Related Facts", the statements of which are evaluated on a simple "True/False" scale and are designed to add further insight into the long term grief process of the assessee.
    The unadulterated assessment is divided into two lists of statements, Past Behavior and Present Emotional Feelings. Participation requires the assessee to rank her/his agreement with each statement on a five level scale as follows: a = completely true; b = mostly true; c = neutral; d = mostly false; e = completely false.
    It's hard to find any specific information about scoring on the internet. This may be because distributors of the test are wary about its use for self-assessment. The most complete explanation I found is on page 2 of 6 when this article is opened in one's Adobe Reader; the journal in which the article appears lists the page number as 516. This explanation is particularly interesting because it compares responses to Part I with responses to Part II in an attempt to assess the possibilities of delayed grief and prolonged grief. Pages 10 an 11 of this Power Point article (which opens as a pdf file) presents a scoring explanation which is down and dirty, thus easier to understand and utilize casually. Essentially, when rating one's answers, one scores one's a-e selection on a five point scale, giving one point to "a" answers and sequentially upgrading to five points for "e" answers. The lowest to highest score one can accumulate on Part I is 8 - 40. For Part II: 13 - 65. Informally speaking, the higher one scores, the lower is one's experience of grief. In my research of the TRIG (which was admittedly brief, confined to maybe an hour and a half of clicking into links from my Google search and scanning the articles) I found no evidence of anyone using the assessment to determine levels of "healthy" or "unhealthy" grief. I find this a relief, as it indicates to me something advocated by some of the grief literature I've lately perused: That grief is a highly individual experience and the meaning of ease or difficulty with grief must be considered within the unique circumstances of each Grieving One's life.
    The assessment (and its adaptation) is meant to be administered to the grieving survivor a fair while after the death. Although I found nothing specific to suggest the following, my guess is that Part II and Part III of the adaptation, depending on the circumstances in which the assessment is used, can be and probably are administered multiple times. In the original TRIG, Part I focuses on memories of fresh grief responses immediately after the death; Part II attempts to assess how one has moved through grief and where one is "now" in the process.
    Although it is meant to be used in a formal setting, no doubt proctored and evaluated by a professional, I found that self-(ab)use (I couldn't resist), reading the statements, considering them, even assigning a number to one's grief and comparing it to highest and lowest scores, can be enlightening. On April 14, 2009, when I discovered the TRIG, I decided to take it "straight". My results on Part I were 26 out of a possible 40. My results on Part II were 43 out of a possible 65. Considering that I scored about the same (by percentage) in Part I (65%) and Part II (66%), I surmised that this might indicate that I am handling my grief about the same now as I was when my mother died. This surprised me because it has seemed to me that I am grieving more than I did right after Mom died. As I looked back over the statements and rummaged through the thoughts that each statement aroused when rating them according to how they applied to me I realized that what is likely happening is that I am expressing my grief more freely and understanding it better than in the immediate death wake; responses the TRIG doesn't differentiate in terms of "more" or "less" grief.
    Because I am obsessively self-analytical, I thought it would be entertaining (more for me than you, I suspect) if I include here a review of thoughts I had as I rated the statements, along with how I rated them. Keep in mind that the statements (which I'll display in this color) were developed by Thomas R. Faschingbauer, Richard A. DeVaul, and Sidney Zisook and copyright by TRIGs publisher, American Psychiatric Press:

• Part I:
  1. After this person died I found it hard to get along with certain people.My rating: c (neutral)
     My thoughts: Yes, in that I was unable to contemplate any kind of difficulty in sorting out death business during the week immediately after my mother died while relatives were here. Two examples: One relative, the day that my mother died, warned me to immediately transfer almost all money in Mom's & my joint checking account into a new checking account before the bank found out about the death because the experience of friends told him banks tend to freeze accounts when one of the holders dies. My response was, "I can't handle this, I don't want to hear about it." The relative was wrong about this. Some days later, after immediate death business had revealed itself to be pretty easy, straightforward and not at all threatening, yet another relative related experiences of yet more friends who had been devastated by inheritance and estate taxes, losing "40%" of their assets to such. My response was the same as to the example above. Again, the relative was wrong, at least about my situation. My mother's estate is subject to no death taxes from either the state or the feds and I am not subject to any inheritance taxes.
     Other than abruptly dismissing what I considered frightful absurdities, which I usually don't do (I usually take them on and analyze them in order to confront the absurdity and dissipate the fright) I was just as sociable, more so, actually, than usual, as quick to laughter and to tears, as good at listening as I was at talking and had no specific, unusual problems with anyone.
  2. I found it hard to work well after this person died.My rating: a (completely true)
     My thoughts: I was numb, completely unable to attend to household duties or death business. I left it up to everyone else. I was, however, aware enough to realize what people were doing for me and thank them profusely.
  3. After this person's death I lost interest in my family, friends, and outside activities. My rating: c (neutral)
     My thoughts: I did lose interest in activities that involved my mother [watching movies; reading, both silently (which I'd lost interest in over the last four years of my mother's life, anyway) and aloud; cooking; some areas of conversation; internet related activities; stuff like that], which accounted for quite a few activities. However, I redoubled my interest in most activities that didn't involve my mother and which had lain fallow over the last several years; and, I did this almost immediately after the first wave of relatives left. It was a relief to do so. The only people I could be said to have lost interest in were the many Hospice people who had become indigenous to our lives for seven months. I didn't think much about this. They were no longer contacting us (except for the grief counselor) and my assumption was that they were no longer funded, so they dropped off my list of people to contact.
  4. I felt a need to do things that the deceased had wanted to do.My rating: e (completely false)
     My thoughts: Unless the "thing" was expedient, using the ordered Christmas dinner and goodies, for instance, to feed mourning visitors and using the rest to provide a Christmas feast at one of my sister's homes (I attended the feast), there was absolutely nothing that I felt I "needed" to do in deference to my mother's desires after she died. I was, in fact relieved that there were some things I wouldn't be doing: Christmas baking, for instance; continuing to watch episodes of Touched by An Angel.
  5. I was unusually irritable after this person died.My rating: c (neutral)
     My thoughts: This harked, for me, back to #1. While my response to the fright and absurdity factors suggested by others was unusual, my disdain for them was not. Otherwise, I was no more or less irritable than usual.
  6. I couldn't keep up with my normal activities for the first 3 months after this person died.My rating: c (neutral)
     My thoughts: Considering that most of my normal activities involved caring for my mother, which I was doing to a heightened degree by the time she died, this, I figured, was obvious but to be expected; nothing unusual. Otherwise, I cared for myself and my life in pretty much the same way that I did when my mother was alive.
  7. I was angry that the person who died left me.My rating: e (absolutely false)
     My thoughts: I was not angry that my mother left me. I didn't even think about this one. Her death had nothing to do with her choice in the matter. Later, though, in my grieving process, I became (and remain) angry that there is such a thing as death.
  8. I found it hard to sleep after this person died.My rating: c (neutral)
     My thoughts: I didn't find it hard to sleep and have never gotten any more or less sleep than I did when my mother was alive. I did find it hard to sleep in my room after my mother died. I still do, occasionally. I prefer sleeping in the living room. I've decided that this is because the heart of our home is there and my preference, still, often, is to snuggle in that heart.
• Part II:
  1. I still cry when I think of the person who died.My rating: a (completely true)
     My thoughts: Absolutely, and without shame or discomfort. It feels good to cry, so I don't try to stop tears, ever, even in public.
  2. I still get upset when I think about the person who died.My rating: d (mostly false)
     My thoughts: I have almost never gotten upset when I think about my mother after her death. Occasionally I am upset with Death, but not about my mother or her death. I know, sounds confusing, but that's how I'm processing it.
  3. I cannot accept this person's death.My rating: e (completely false)
     My thoughts: I can accept my mother's death. I'm just having a hard time accepting Death, which is a surprise because I never thought I'd ever have a hard time accepting Death. I've done really well with this, up to now.
  4. Sometimes I very much miss the person who died.My rating: a (completely true)
     My thoughts: Oh, always...always. I can't, yet, imagine not missing her. This also causes me no shame or discomfort.
  5. Even now it's painful to recall memories of the person who died.My rating: e (completely false)
     My thoughts: I LOVE remembering my mother, love talking about her, love thinking about her. There is nothing in my memories of her and our life together that has been the least bit painful.
  6. I am preoccupied with thoughts (often think) about the person who died.My rating: d (mostly false)
     My thoughts: I wavered between "d" and "e" on this one. I chose "d" primarily because there have been a few times, even now, when I've been unpleasantly surprised by sudden intrusions of my mother and the stab of longing these evoke: When, for instance, I am in Costco but no longer buying supplies for our lived-together life; when I buy fast food for one but cannot divest myself of my mother's preferences (even though I don't buy those preferences, I buy my own).
  7. I hide my tears when I think about the person who died.My rating: e (completely false)
     My thoughts: Nope. Not a chance. I'm not wired that way.
  8. No one will ever take the place in my life of the person who died.My rating: a (completely true)
     My thoughts: I consider this a rational and completely good response. Of course no one will ever take her place. No one has ever taken the place of anyone who has left my life. This just isn't possible. I don't believe this is possible for anyone. I further wonder if it isn't both unrealistic, suspect (from the point of view of grief) and maladaptive if people think this can happen and look for it to happen. If I had set up the scoring standard for this test, I would have reworded the statement thus: "I'm expecting, or have already found, someone to take the place in my life of the person who died," thus giving the "high grief" (which would be the lowest numerical) score to those who rated the reworded statement "a".
  9. I can't avoid thinking about the person who died.My rating: c (neutral)
     My thoughts: Of course I can't avoid this. Nor would I want to, not even when the thoughts seem like an intrusion, as mentioned above. I suspect the underlying assumption with this statement is that the respondent might want to avoid thoughts or considers the thoughts as obstacles to other thoughts. I don't, even when those thoughts are intrusive.
  10. I feel it's unfair that this person died.My rating: e (completely false)
      My thoughts: I don't consider it unfair that my mother died. Death is what happens to all of us. I have lately, however, been feeling that Death, itself, is unfair. I wonder, in fact, why grief assessments and grief counseling don't seem to distinguish between feelings about the death of a person and feelings about Death, in general, especially since, in my case, the two have separated themselves and I'm having a problem with the latter, not with the former. Although I may be wrong, I'm guessing that I'm not the only grief-stricken survivor who does this. I've considered that my separation of these might be a response my psychology has designed to keep me from realizing that I am angry with my mother for dying, but this just doesn't fit. It makes no sense to me to be angry with her or cite her, personally, with the unfairness of Death. She didn't create the circumstance of Death. In fact, in her own mind, she erased that option well over a year before she died. Even in the case of suicides, and I've known two people who committed suicide, I can't bring myself around to thinking that their choice of the option to die is what creates the circumstance of Death...thus, anger and a sense of unfairness didn't, in either of those deaths, enter into my equation, either. Call it a personal quirk.
  11. Things and people around me still remind me of the person who died.My rating: c (neutral)
      My thoughts: When I thought about this I was surprised that, despite occasional unwelcome and unpleasant intrusive reminders, I am not more often reminded of my mother by "things and people around me"; not uncomfortably surprised, just surprised. Considering how close we became, how every aspect of each of our lives echoed in the life of the other, you'd think that I would be constantly and disturbingly reminded of her. But, I'm not.
  12. I am unable to accept the death of the person who died.My rating: e (completely false)
      My thoughts: Once again, it's not my mother's death I am having trouble accepting. It's Death.
  13. At times I still feel the need to cry for the person who died.My rating: a (completely true)
      My thoughts: I remember, when rating this statement, thinking, "Actually, I don't feel the need to cry for my mother, rather, about my mother and how much I miss her." I almost rated this one "completely false" but decided to give the benefit of the doubt to the statement and assume that the developers were implying "about" when they chose "for".

    What did I find "enlightening" about self-administering this assessment?

1. Although I knew that, for me, there exists a dichotomy between my mother's death and Death, I didn't realize, until performing this assessment, that there isn't professional grief counseling acknowledgment of this dichotomy, why it might exist and what the consequences are of allowing it.
2. Previous to assessing myself I suspected that I was not handling my need to grieve as well as it seems as though I am.
3. The assessment informed me about aspects of grief and allowed me to confront them as specific events, sometimes isolated from other grief events, rather than thinking of grief as one amorphous event. The former approach makes grieving easier, for me, anyway, because it helps me locate myself within the process. The latter approach tended to make me feel as though I was traveling through a labyrinth, one out of which I might never emerge.
4. It helped me realize what, about my behavior, might be specific to grieving and what isn't. Although my confusion about this wasn't overwhelming, it was barely noticeable, in fact, the added clarity was welcome.

    The TRIG appears to be a tool fairly widely used by professionals dealing with those of us ensconced in grief. This suggests that it is useful. It isn't the only tool. I've run across another, the G(rief) A(nd) M(ourning) S(tatus) I(nterview) [and] I(nventory) [GAMSII], especially applicable to complicated mourning, that is equally intriguing and upon which I will probably comment in a later post because it promotes a decidedly different and more personal method of assessment. Since I'm not a professional counselor, let alone a grief counselor, I'm not inclined to criticize the TRIG, despite my critique of Item #8 in Part II. I can see that it's a good organizational tool for thinking about someone who's grieving and seeking information about unique grief profiles. I'm not worried that it might be misused by encouraging counselors to ignore the eccentricities of one person's grief in favor of simply locating them, à la psychological GPS, in The Forest of Grief. I think that viewing grief is an experience that is most likely to provoke awe from any observer, professional or not, and would tend to cause a professional counselor to be more, rather than less, careful about soliciting information and giving advice.
    Would I recommend self-administration of this assessment to people? I would to people who tend toward and enjoy rigorous self-examination and are not prone to diffuse and critical worry about whatever psychological state in which they might find themselves at any particular time for any particular reason. I would to people who tend to harbor a lively and objective curiosity about themselves even if they aren't particularly self-conscious or self-absorbed. I would not to people who might tend to frighten themselves unduly with discovery about their psychological states or if they were normally intent on being oblivious to their psychological states. I also would not recommend it to people who seemed, at the time of the consideration, emotionally fragile, no matter what their previous behavior revealed about their normal emotional profile and self-interest.
    If you're as intrigued as was I, though, give it a go. It's involving and fun, yes, fun, if nothing else.

Labels: Complicated Grief, Grief Self-assessment, Slate, TRIG

    I conceived of this subsection of my journals at the same time I decided it was time for me to commence some serious reading about grief, as I mention in this post at my regular area, The Mom & Me Journals dot Net. It's just taken me awhile to get going over here.
    My current plan is to write all my grief stuff, from here on out, in this area. That doesn't mean my main journal will stagnate. I continue to have a lot to write about caregiving and other aspects of my mother's and my journey. Those will continue to be posted in my main area. It just seems as though I'm ready to section off my grief, I guess that's the best way to put it, to make a distinction between my grieving and the rest of my life. I can't say what this indicates about my emotional state...for the time being I'll let others, if they are so inclined, speculate on that.
    Currently, these are the books I've either checked out of the library or already have that I intend to read over the next few weeks to months. I'm placing them in the order in which I intend to read them, although I've already begun reading three of them at once and one is already read but is in the stack for rereading:

1. A Grief Observed by C. S. Lewis
2. How to Survive the Loss of a Love by Colgrove, Bloomfield & McWilliams
3. Treatment of Complicated Mourning by Therese A. Rando
4. On Grief and Grieving by Elisabeth Kubler-Ross & David Kessler
5. Nothing to Be Frightened of by Julian Barnes [which I own and have already read once]
6. The Year of Magical Thinking by Joan Didion [which I own and have placed last, saving it for dessert]

    Once I'd compiled the list and alerted my library to pull the first four from the stacks of libraries throughout my county, I was alerted, through Pallimed, to a series of seven articles on grief by Meghan O'Rourke at Slate. I was astonished to discover that most of the books she mentioned reading are books I'd selected to read, save for the playbook of Shakespeare's Hamlet, although I'm wasn't surprised at how she reinterpreted the play after her mother's death. When I'd studied the play in a college class in the mid-1970s the emphasis of the instructor was placed on a mourning Hamlet. O'Rourke's comment that after a cursory reading of Kubler-Ross' book she "threw it across the room in a fit of frustration at its feel-good emphasis on 'healing'" didn't surprise me, either. My experience with and understanding of Kubler-Ross' work is similar to hers. I checked the book out, though, because I noticed, when leafing through it at the library, that at the end both authors write about their personal experiences with grief. I thought that would be interesting. Also, although O'Rourke doesn't mention Therese A. Rando's book, article 3 in the series suggests that she probably has a familiarity with it.
    As I read through the series of articles I was intrigued by some of the concepts: finding a metaphor for death; mention of the Texas Revised Inventory of Grief, which I looked up and which amused me because it submits grief to an industrial-civilized test; the question of whether The Dying One accepts her or his Death. As well, I was attracted to the series because O'Rourke's mother died just seventeen days after my own. Upon learning this, there was an immediate and uncontrollable urge to "compare" my experiences with hers. As I read the articles, though, I realized that such comparisons are folly. I knew this, but, well, my autonomic brain is also a product of an industrialized civilization.
    Anyway, aside from writing my usual grief stricken posts Here instead of There, my plan is to react, explicitly and in writing, to what I read as I browse the literature. I'm not promising that I'll write any more often than I'm presently writing Over There. Reading and writing about death and grief isn't all I'm doing. But, I thought it would be handy and helpful (for me) to separate this aspect of my journaling from the other aspects. I may be adding books and articles, which I'll catalog here, of course. I may not read every single word of every single book. Primarily, at the moment, I don't expect to read either #3 or #4 in their entirely.
    One last note: The search engine for this section hasn't been set up or linked, yet. It will, soon, but at the moment it's not.

Labels: Grief Literature, Introduction, Slate, TRIG