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Loss and Grief (Part 1)

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Anshu Bahanda: This is Anshu Bahanda on Wellness Curated. Thanks for joining me on this podcast. My mission is to empower you with health and wellness so that you can then go and empower others. Ramesh bhai, Hari Om, how are you?

Dr Ramesh Pattni: Fine. Hari Om. How are you?

AB: I’m very good. I’m really excited about this talk because I’ve been thinking about it for years, but I’ve never had the courage to approach a topic like this.

Dr. RP: Sure, yes. It’s not an easy topic and I think some people may find it quite uncomfortable to even speak about these kinds of things. And I think it’s important that people actually begin to think and explore and talk because it does provide some basis for them to then respond as to how they need to respond.

AB: Yes, and I wanted to discuss this topic for a long time. I just didn’t have the guts to do it. Like you said, it takes a lot of courage to talk about loss and grief because it also makes you see that we are going to lose people we really care about and maybe even jobs. 

Just for all of you listening, we’re going to do this in two parts because it’s quite a heavy topic. Dr Pattni who is a theologist and a psychologist will be giving us a brief explanation. He holds three master’s degrees and is a doctorate in yoga, he also tutors at the Oxford Center for Hindu Studies. He has a stellar CV and also works as a counselor and psychotherapist, assisting people to regain well-being and resilience. He was recently given an OBE [Officer of the Most Excellent Order of the British Empire] for services to the interfaith and the Hindu community. He has been of great help to me in my personal well growth, well-being and personal development and a lot of people around me. 

And as you know, due to the circle of life, we’re talking about a topic of loss and grief today. And we’re all going to lose people throughout our lives or we have already experienced loss. And if it’s not that, it’s jobs, it’s relationships. And what I think is incredible about Ramesh bhai, as I call him, is that he has an uncanny ability of taking very complex principles and explaining them in such a way that we understand them. So, welcome to the chat, Ramesh bhai.

Dr. RP: Thank you so much Anshu, it’s a pleasure to be here and hopefully this podcast will help explore the topic well, which I think is very relevant. 

AB: Thank you. So, my first question to you is what is wellness to you?

Dr. RP: Anshu wellness for me is about having a holistic vision of health and making appropriate choices according to that vision that will take you there. So, it is having that vision and making choices according to that. And these choices are in all dimensions of our life. So, we are talking about the physical dimension, we are talking about the psychological dimension, we are talking about relationships as well as about the spiritual dimension. So, taking all of that together and making the right choices according to a certain holistic vision, that we have.

AB: Okay, will you get into the topic straight away and explain loss and grief to us?

Dr. RP: Okay, so, let me talk about loss first. So, loss in fact, as we know, is a state of being deprived of something or someone. And it can be an actual loss, just like you were describing before, we lose somebody significantly in our lives. Maybe it’s a family member, maybe it’s an acquaintance, a friend or some relationship that we have. And we know that this is a universal fact of life. It is an existent fact of life that we are born and we are going to die. According to Hindu tradition, of course, we know that even when we die there are chances of us coming back again. But it is a fact of life. For example, if you think about the UK, 700 deaths occurring every year and if five people are affected by one death, imagine that more than 4 million people are being affected by loss in a very real sense and how are those 4 million people dealing with it? That is the whole thing. And the grief and the loss which is experienced will be for these four or 5 million people. And even in COVID, it’s much more, of course. So, it can be that kind of actual loss, but it can also be symbolic loss like you talked about earlier. For example, if somebody loses a relationship or goes through some kind of divorce, there is a significant loss of relationship as well. You can lose a job. One can also lose meaning and purpose in life and go into a kind of loss about meaning. And that can be very severe in terms of creating a depressive state of the mind. And also, you know, sometimes we have a dream when we are growing up and having dreams like, oh, I’m going to do this, going to do that, by the time you reach midlife, those dreams are gone and that is an actual loss. So, sometimes a midlife crisis is a loss which has not been realized. The dream which has not been realized becomes a loss. So, it can be a symbolic loss. And to talk about grief, we must understand that it’s a natural response. It’s a reaction to such an actual or symbolic loss that we are going to experience all our lives. And also, that it is normal and it is natural. So don’t say grief is a problem. It’s not a problem. It’s a natural and normal adaptive response to loss. And this is a very complex reaction, as we will see. And the thing to understand, Anshu, is that you cannot fix or cure grief. Remember, grief is not about curing something. Human grief is a kind of complex experience of various different thoughts, feelings, and sensations even in the body and behavior which enable us to survive. It is a survival response in one way of thinking. So, how one responds to loss is based on our assumptions about life and living and that also plays into it. So, it becomes complex in terms of understanding the experience which is— in many cases loss will challenge our assumptions about life, and how we are able to deal with the challenge of loss, is actually experienced as grief in our life.

AB: So, if you repeat that, loss will challenge our assumptions about life.

Dr. RP: That’s right. So, loss may challenge our assumptions. For example, if I assume that this relationship is wonderful, it’s going to last forever, nothing is going to happen to it. And I have this firm belief and a certain attitude in my mind when it comes to the loss, that assumption is now challenged, that belief is now challenged. And when that belief kind of hates the challenge of the reality of the situation, this is when we start experiencing loss, we start experiencing the grief response. So, grief can also be seen as part of dealing with this threat. So for example, if I’m attached to somebody and if I lose that person, it becomes a threat to my existence because this person was so close to me. And if I get so much attached to my job and profession even then if I lose that job and profession it can create a crisis in my life like I don’t know who I am, I don’t know what to do. I’ve lost my job and it was taking 16 hours of my day, all that is gone and it leaves a big vacuum so that I don’t know how to fill it and I can’t respond to it in a kind of way that will take me through this grieving process. So, it does challenge us in many different ways. Loss will challenge us from one way or the other right from the age of one month till 100 years. Some kind of loss will always be challenging us. And how we deal with this, is our grief response. And we know that grief can also or this grieving response can also go wrong because we are not able to deal with that. And it can become extreme, it can become so prolonged over many years, that if somebody passes away and is grieving even after 20 years that means he/she has not come to terms with it. And not only that, but some people get into an intense depression as well. So that is something to watch out for. And if that depression becomes clinical, it becomes something that makes a person dysfunctional, then it is important to get some professional help. Always remember there’s nothing wrong with getting professional help. I know there are people who have negative attitudes about getting professional help, but what would you have, 20 years of grief or something, which you can process with a professional and say, okay, now I want to begin to understand and come to a reality about my loss. So that’s also important to understand.

AB: So, Ramesh bhai, when you talk about professional health, sorry to interrupt, are you talking about medical or non-medical? 

Dr. RP: Yes. So, I mean a holistic way of looking at this. So. If I need to go to the GP, yes, I will go to the GP. The GP may kind of examine me physically and ask me questions. Then he will refer me to a psychotherapist or counselor and say, get some kind of mental health support. Because you’re going through this grieving process and it is affecting you so much, you have to kind of try and do something about it. Remember, there are some myths about grief as well. So, one of the myths is that time is going to heal. Actually, time doesn’t heal. What heals is how you actually play your part in time. You see what I mean? So, time can keep on going, but you are not doing anything about it. But if you play your part in time, then time will begin to heal. And also, sometimes people think, oh, this person is crying so much and is not able to deal with this grief. Actually, that is the normal expression of loss and grief. So, somebody crying away means that that response is coming. This response is coming and please allow that person to cry, be present for them, be there with them, and help them to take that grief and loss into this kind of expression. So, it is important to remember some of these things about grief. So, that is loss and grief.

AB: Okay, so that’s quite a lot to process. But what are the different stages in loss and grief and how are they affected? How do we deal with them at different ages of our lives?

Dr. RP: Yes, so we can understand it this way. So, first of all, to know that we can see that there are four different components of grief. So, on one hand, there is a physical component. So, you can have symptoms like lack of energy. I don’t feel like doing anything. There is stomach ache, and health effects such as reduced immunity as well. So, physical effects are there. Secondly, psychological effects of all kinds of sad feelings will come about. Sometimes screaming, rage can also come about. Guilt and shame can be experienced. And this also has quite a cultural element as well that how we acknowledge grief and how we kind of express grief. So, that is the first and the second part of it. The third part is that there is a kind of psychological disturbance of thought processes as well. So, there’s an emotional component and there’s a thinking component. So, you may not be able to concentrate. You can keep having a lack of motivation. You feel as if you’re numb. That is also there. Then there is a social part of it. Physical, psychological, social. Now this social part, there can be changes in relationships so that if a family member is lost then there is a change in relationships which can also be experienced in that kind of way. The fourth component is spiritual. So, sometimes even that spiritual element comes into it. And it can either be in a negative way whereby we lose faith in God because God has taken away this thing from me, taken away this person from me, or it can be something positive because I’ve got this faith which holds me. And this faith that is going to hold me, is going to help me through this grieving process. 

So, in the stages of grief, there are actually five stages of grief identified. So, the first stage is that people actually say no, this can’t be happening to me. No, it cannot be true, this person has passed away. So, there is a kind of disbelief and denial. That’s the first stage. It may also last very long but definitely it is going to be there. Oh my God, this has happened. I can’t believe it. I can’t believe it. That’s what we start saying. And then anger. Why did this have to happen to me? Anger. This is a way in which we start kind of striking out at people and everything else and say why did these people not do this? And this loss was because of this person and that person and so on and so on. So, anger comes to it, that is the second part of it. The third is that we start negotiating, bargaining and there’s mood disturbances, sadness, and everything starts coming about. There is a kind of depression, numbness and finally the person begins to realize that this loss is actually real and this negotiation is taking place. Then the fourth stage is whereby slowly by slowly you get into a lower and lower mood, depressive mood, mood disturbance which is kind of talking about the full impact of this loss. And finally, slowly, by slowly the person begins to adjust, becomes more realistic about it and accepts and begins to look toward the future rather than the loss which has just been experienced. 

So, we can identify even four different tasks of this grieving process. Mourning, what we call normally we call mourning. So, first is to accept the reality of the loss, number one. Number two is to work through the pain and grief. To work through means process, keep on processing. If it needs help from a family member, you can support somebody, just go ahead and do that. Thirdly, to adjust to the environment where this loss is experienced. So, you may lose a significant person in the family. You begin to adjust to the new kind of dynamic which is there. And finally, to emotionally relocate loss and move forward with life. And emotionally coming to terms with it allows us to look towards the future rather than regretting and kind of mourning the loss which has happened. So, these are the four things everybody has to do in order to come to terms with grief.

AB: Okay, and is it affected by age?

Dr. RP: Yes, it will be affected by age. So, to kind of think about that, if a child experiences loss, for example, if a three- or five-year-old child loses a pet, I remember that my daughter lost her hamster and she was grieving so much. And I wait to hold her and say, okay, now this is the normal thing. I’ll try to normalize it to say this is what happens all over the place. This is going to happen to you. And remember that we have to treat this hamster with some dignity. Let’s go and  do something about it. We can go and bury it somewhere and so on and so on. So, going through the process in a systematic way, in a very supportive way, sensitive way, being present for the child, so the child will also experience, but it will be different when the adolescent experiences and it will be different when the adult will experience. And we can explore that in the next session as well. But certainly there is a difference in terms of the age at which you experience this loss.

AB: Okay. And Ramesh bhai, because loss is inevitable and so is grief, how do we prepare ourselves for this? Can you give us some tools and techniques?

Dr. RP: Okay, I think the first thing to remember is there is no absolute preparation for grief. You cannot absolutely prepare for grief. There are people who say that, yes, you can become so resilient that you can be able to deal with grief. But for the majority of the people, it is difficult. But there are two main approaches we can think about. Number one is that research is showing that people who are proactive in coping, coping with change, will be able to deal much better with grief and loss. That’s number one. Number two is people who are naturally resilient. Resilience means the capacity to spring back into a normal kind of way of functioning. Now that resilience can also be developed, it doesn’t mean that resilience comes either if it is there or not there. So, two things. Number one, proactive coping skills. This we can learn. So how do we learn coping skills? 

Number one is that you can learn it as a problem-based coping skill. So, look at things as a problem and say what is the solution if I treat this as a problem? So for example, if I say I’ve lost my job and I see that as a problem to be solved, then I start thinking of it in a more positive way. Then it is a solution-focused approach. And if I take that, then it allows me to open up possibilities as to how I can cope with this loss. Number two is that [it is] emotion-based. So, one is problem-based coping, which means I learn to see how things are, objectively approaching problems to solve them, naming and exploring problems, finding out the possible solutions, and then seeing what’s the best optimal solution for that. Emotion-based means that you’re practicing your kind of mindfulness and that becomes an excellent skill for dealing with this kind of emotional upheaval which takes place. Learning how to hold and process emotions and self-acceptance is one very important part of emotional coping skills. If you’re able to accept yourself and accept who you are and what your capacities are. And self-compassion goes with that as well. Self-acceptance, self-compassion, cultivating optimism, learning how to self-care, knowing how to relax using those breathing techniques, even yoga exercises, even using art. I know that you are into art, and you know that art can itself become a very therapeutic tool….

AB: Yes.

Dr. RP: … for processing our emotions. So, use any means which can kind of begin to take you towards processing that kind of emotional way. The other thing is how to build resilience. Now, that takes a bit of time and I think that  when we are talking about different ages and different stages, if we begin to make our children to be more resilient as they grow up… What is resilience? It’s the capacity to deal with challenges in life. And the larger the capacity, the bigger the resilience you have. So, that you immediately kind of stand up and start going, okay, so now how do we build resilience? Number one, finding meaning and purpose in life. If our vision is clear, this is my meaning, this is my purpose in life, I will know what to do every moment because everything is then related and connected to that higher purpose or whatever purpose we kind of develop in our life. Number two, cultivating positive self-belief. Cultivating positive self-belief, which I have, I know that I am this person and I am this person who is able to deal with it. I have belief in myself. You see what I mean? So, that’s number two. Number three, understand, accept and embrace change. Some people are not wanting to understand or not embracing change. If they learn how to embrace change and cultivate that kind of capacity to embrace change, they become much more resilient because change, yeah, it is going to come. I know how to deal with it. Number four, creating an optimistic mindset. Create a mindset that is always going to look towards positive things, and thinks, okay, this is the worst thing that’s happened. Let me look for something which is going to look at a perspective that is optimistic. Number five, cultivating and maintaining self-regulation. In other words, then I’m able to process emotion, I’m able to process my thoughts, and I do it in the most efficient manner. If I’m able to do that, wonderful. You can immediately start bouncing back. And the next one is also very important. Establish a wide and strong social support system. Not only within the family, extended family, but friends. Having a network of friends can be so beneficial in terms of giving that support. Whenever we experience that loss, the stronger the network, the more resilient you become. And the last one, keep learning and practicing these coping skills, which I just mentioned, problem-solving-based and emotional-regulation-based. And if you can kind of do that as a package: coping skills, resilience develop and keep on developing, then it will be able to help us.

AB: Okay? Now, Ramesh bhai, I’m going to very quickly ask you the last question. How could we prepare others for this? And at what age should we start working with our children?

Dr. RP: Let me answer the question about children. So, for example, between three and six years, as I was saying, they get very frightened. They get frightened of loss and they have difficulty in focusing. Sometimes they withdraw, they become subdued, and they can also become very extreme, kind of very aggressive as well. So, here are a couple of, kind of, pointers for that. Explaining loss to them and change in very simple terms. Even through stories. There are many beautiful children’s stories that explain loss and grief. So, to kind of tell them in their own kind of way, understanding, explain that to them. Number two, answering their questions openly and honestly. Don’t try to deny, don’t try to brush it away, but be honest. Be open to them and tell them, yes, this is it. This is how it works. This is what you’re going to experience. Don’t get frightened. But here’s a way of dealing with that kind of fear, assuring children that their own security is going to be there even if they face any kind of change. So, in other words, I’m here for you. You don’t have to kind of, you know, be insecure about this loss and change which you are experiencing. I’m here for you. We are all here for you. We are going to support you, and so on and so on. And finally, to encourage mastery of this emotional and cognitive regulation as much as we can kind of make them understand. Okay, if you feel frightened, here’s what you do. Take a deep breath, keep on breathing, focus on your breathing and just let go of your tension and anxiety. So, they become more confident in dealing with loss, dealing with change.

AB: Fabulous. Thank you. That was a lot. I’m going to go over this about three or four times. For everyone listening— it’s going to be the same. And Dr Pattni dealt with understanding and preparing for loss and grief this week. Next week, he’s going to talk about dealing with loss and grief. Thank you, Ramesh bhai. What a pleasure that session was.

Dr. RP: Thank you.

AB: Thanks for joining us. Hope you enjoyed the Wellness Curated podcast. Please subscribe and tell your friends and family about it. And here’s to you leading your best life.