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Author Topic: Grieving Mental Illness - Virginia Lafond  (Read 3328 times)
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« on: March 17, 2014, 08:25:59 AM »

Grieving Mental Illness: A Guide for Patients and Their Caregivers
Author: Virginia Lafond
Publisher: University of Toronto Press (November 23, 2002)
Paperback: 136 pages
ISBN-10: 0802085326
ISBN-13: 978-0802085320




Book Description
This is a good self-help book for parents with a child with mental illness, such as BPD. The author discusses the normal pattern of emotional reactions to the losses and changes that mental illness brings into our life in an effort to help us understand and find some level of acceptance and peace.

There are very real losses associated with any illness and grieving for them, whether the grief is recognized as such or not, is inevitable. Unacknowledged grief takes its toll, slowing or even stalling recovery. Using grief as a healthy, normal, adaptive process enhances recovery, allowing positive choices to be made. By consciously grieving we can help bring healing and wholeness to our lives, resulting in new ways of coping, reduced stress, and greater self-esteem. It helps to come to terms with the illness - especially as we prepare a loved one for success in rehabilitation programs.

First published in 1994, this revised edition contains a new introduction and two new appendices: 'A Worker's Guide for Working with the Grief of Mental Illness' and 'Mental Illness: Responses to Frequently Asked Questions.'

About the Author
Virginia Lafond is a social worker in the Schizophrenia Service of the Royal Ottawa Hospital.  As both - a social worker and a sufferer of a mental illness, the author understands the grief that is connected to mental illness.  

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« Reply #1 on: May 11, 2014, 06:21:51 PM »

I found this book very helpful. In many ways it is comforting and it is very different in its approach. The author gives us her "road-map" for a healing journey through the stages of grief (similar to Elisabeth Kübler-Ross model) and shows how we can work with our feelings, rather than struggle against them.

Who wouldn’t be relieved to hear that it is actually ok to not feel ok in the face of mental illness (ours or someone else’s)? That feeling uncomfortable at times, or not knowing what we are feeling is normal? That the grief that we may not even consciously know about is a healthy response to the tremendous losses that the mental illness brings about?

Yet the book strikes a good balance – while you are encouraged to feel your feelings and learn different ways to cope with them, the ultimate goal is to work through the grief. While we are nudged to explore our feelings and deal with them in a safe and constructive way, we are not encouraged to wallow in them unproductively. This is a time of nurturing ourselves through a difficult time, rather than telling ourselves to 'get it together' or to 'pull ourselves by the straps of our boots.'

In the beginning, she says, people tend to focus on problem solving. Then, the stigma associated with mental illness can drive us and our loved one into isolation. That way grief can go on unnoticed or unacknowledged by the person who is ill, and their family. Yet, grief will work its way through our lives. The feelings will be there, and will be at work. According to the author, in order to benefit from the process, we need to decide to "grieve consciously."

Otherwise, we may get stuck for too long in one stage, or find ourselves swinging between anger and sadness forever without reaching acceptance. At the same time, she warns us to remember that too long as well as forever in these circumstances are very individual terms to be approached with great caution.

So, how do we go about grieving consciously? First, we learn about what she calls the Two Key Coping Questions ("1. How can I help myself cope with …." (insert feeling of circumstance), "2. Are there ways I can use this experience of … constructively?" If we are dealing with a feeling, we are working with the energy of that feeling. If we are dealing with a circumstance, we are looking at knowledge we have gained. Can we do something about our situation? If Yes, do it. If Not, practice letting go.

These two coping questions are our companions through the grief stages, and whenever we are ready to use them, she tells us it is important to find a safe and relaxing place, invite a friend if we can, be gentle with ourselves and not sabotage our efforts by thoughts such as: 'I shouldn’t be feeling this way,' or 'this is unimportant'. If your therapist is discouraging you from grief, find one that will help you through it.

I. DENIAL (defined as lack of insight into one’s situation)

It’s been recognized that denial is a healthy coping mechanism that acts as a buffer to protect us from the intensity of painful experiences. It’s not something we choose, it happens naturally (to both, the mentally ill person and their family members and caretakers).

The denial of the mentally ill person is another loss for loved ones and can be a source of despair. Lafond suggests to keep this in perspective (denial is a necessary stage), and to keep up hope. Our messages to the mentally ill person should be easy to understand, gentle, short and clear, free of blame, and conveyed with respect.

Asking the 2 coping questions will prompt us to look to educate ourselves and also notice other feelings that will lead us into the further stages. It is important to be aware that the continuous losses and the associated pain can temporarily send us back into denial, and that’s normal.

II. SADNESS

It might surprise us to hear that under these circumstances "it’s perfectly acceptable to feel sorry for ourselves." Sadness is painful and the author suggests that we need to develop a gentle, supportive self-talk instead of brow-beating ourselves with "I shouldn’t feel this way." There is a reason we are feeling this way…

We become aware and more in control of the process as we begin making decisions about what to do with these feelings. They become more clear to us, and we can start seeing the 'fit' between our feelings and what happened.

Asking the 2 questions, we discover our options on how to alleviate sadness. There are ways to distract ourselves and do something pleasant or soothing when the pain becomes too much.  We can find our support system (friends, professionals, support groups etc.) Over time (not initially) cultivating a sense of humor and having fun is important. Finding hope in faith can help in times of despair.

III. ANGER

For those of us who look at anger as a pesky emotion to be suppressed and avoided, here is the good news: anger is an important force, a key signal to making decisions and finding solutions. We need to make decisions about the use of our anger. While anger is not an excuse to become destructive, it does have its proper place and function. We can learn to recognize it early on and if we choose to, we can use it productively.

First, we are to look for detail reasons that are causing the anger. That gives us important insights. This process is likely to rev up our anger, so it's best to find a safe place, perhaps even invite a friend who may help us simmer down and find some solutions.

Taking a walk may be a good starting point  – a way to simmer down. Yet, the real solution finding follows after that:

Ask yourself the two key coping questions. Sort out which solutions would be constructive and which unconstructive, then act upon the constructive ones. Try to be specific and make your solutions realizable. The good news about this process is that one decision/solution leads to another.

Some examples of how others used the energy or their anger constructively include: joining a support group, finding professional counselors, writing a journal, continuously educating themselves about mental illness, treatments, community resources.

IV. FEAR

Fear does not represent a separate emotion for a stage of grief. Rather it's a frequent undertone of other emotions. If unchecked, our fears can hold us in a state of paralysis or send us on unproductive rabbit trails. Usually our concerns and fears in the presence of mental illness are reasonable. So, when we realize that it's ok to be afraid, we can learn to face our fears and tame them.

When we focus on our fear, we may find out that it's one big concern, or many little ones that overwhelm us. The best way is to deal with them one by one.

We do that by focusing on what the fear is. If it is something we do not need to be worried about, we can toss it into an imaginary garbage can (and do that every time the fear re-surfaces). If it is something that requires our attention, then we ask ourselves the two key coping questions, and come up with solutions how to face our fear. If we look at how we've dealt with similar situations before, we may have our answer. If this is something new, we come up with new ways to cope. And sometimes we will need the support of others through this.

SAFETY ISSUES: She emphasizes it is important to be informed and ready in case of safety threats to oneself or a loved one. Do not underestimate these possibilities and have a safety plan ready: Safety First.

STIGMA: Stigma connected to mental illness is real, and can be found in a variety of places. The key is to know that stigma exists, and that some people will not understand. Be selective in who we share the information with. We do need support, sometimes close friends are very understanding and supportive.

V. ACCEPTANCE

The acceptance stage, too, is a process and as such requires our conscious effort.

Lafond defines acceptance as "facing the realities brought about by the presence of mental illness and then building and practicing coping skills, so that recovery can be achieved and maintained." By recovery, she means recovery from the trauma that mental illness brought about, even though recovery from the mental illness itself may or may not be possible.

So, how do we get to acceptance? "Insight, activity and affirmation yield acceptance." As we work through the earlier stages of grief, we gain insight and confidence that we can do this and that results in more peace. We keep honing our coping skills, even finding new ones, and we gradually get better. Realizing this motivates us to continue. Even passing on our experience onto someone else is good coping with our grief if we cannot help our loved one.

Insight is our awareness and understanding of the mental illness, and the losses and changes it brings. Educating ourselves about the mental illness plays an important role. Some insights happen gradually, some in sudden leaps. As caregivers or family members, we will understand and grieve the changes to our own situation, the changes of our relationship with the mentally ill person, and most importantly, our new insight will lead us to adjust our expectations for the mentally ill person (which moves us along toward acceptance).

Respecting and meeting your own needs is essential for your physical and mental health. To prevent burnout, it’s ok to have limits on the care we offer.

GRIEF AFTER ACCEPTANCE:

We will meander and re-visit the previous stages, and the accompanying feelings will come and go. We know how to deal with each feeling, we have the needed coping skills, and the coping questions for new situations. With time, the journey gets easier.

When we look back on how we did cope in the past, new sadness and disappointment may resurface, which can plunge us back into hopelessness and helplessness. Be patient, the hope will come back with new solutions in time.

CLOSING THOUGHTS

Grief is an individual process. Expect your family members to be in different stages and for different amount of time. It is normal to be out of synch., which results in conflict. Knowing this can help us recognize it and respect each other through the process: We can only offer ‘good ideas’ to others along the way. It’s best to be very gentle when assessing the length someone’s been in a particular stage (including denial).

On the receiving end, if we get inappropriate pressure from others, we need to apply our assertiveness, respecting our own and the others' position. If we get discouraged by the slowness of our own progress, we are to "adopt a stance of patience with ourselves… affirm the progress we have made," and consider finding professional help.

The author reminds us that occasional failure is ok and profoundly human, by sharing a quote from one of her teachers: "expect to fail not always, but sometimes."

The process of grief is painful. We deserve to treat ourselves with gentleness and care.
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« Reply #2 on: May 14, 2014, 11:00:16 PM »

I'd like to ask you - do you find this information helpful, does it bring anything surprising, new or comforting to your understanding of grieving over our children w/BPD and our relationship with them?

Please feel free to comment.  Doing the right thing (click to insert in post)
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