Before and After Loss: A Neurologist's Perspective on Loss, Grief and Our Brain by Lisa M. Shulman, MD
"I expected grief to be unbearable sadness, but it wasn't that at all. It was profound instability." (preface, page xi)
The above is the quote that starts this book. I read it. Stopped. Read it again. I can relate to that, I thought.
I actually thought that many times throughout this book - which is what I liked the most. I saw myself in the pages. That, combined with the science she describes, helped me understand my own experience of grief and trauma in a much deeper way. Not only that, this book is a rabbit hole of quotable quotes and excellent references. The bibliography is pages long...a gold mine for a book worm like myself.
Lisa Shulman is a Neurologist, and this book is a memoir of her own experience with grief before her husband died, and after, as the title indicates. Her personal experience is combined with her knowledge of how the brain works to organize our reality...and in the case of grief, how it it becomes disorganized and damaged after a loss. The neurology of grief.
Lisa writes about her life with Bill (her husband) when he was sick and dying. The one thing that struck me was how their intimacy with each other was a barrier throughout his illness. "We're stumbling because we care to deeply for each other" (page 6). I found it heartbreaking to look into such an intense and personal time in their life and relationship...but, as Lisa writes later in the book, the trauma and disorientation of loss is based not only in the biology of sorrow, but the biology of intimacy. Our brains are wired a certain way because of our relationships and intimate bonds. Reading about Lisa's life with Bill before his death helps to illustrate this point in the "After" section of the book.
There is something about how Lisa Shulman writes. It is surprising - she captures perfectly, states, emotions and thoughts that I've had, but a) haven't been able to put into words, or b) hesitant to talk about for fear of...I dunno...judgement maybe? For example, her disdain for condolence cards (I remember feeling this way) and her desire to be more a part of "the other side" with Bill, than the side of the living (yep, I've felt this too). In her words:
Condolences: Hundreds were received - all unwelcome. "I'm moved when I sense the grief of others, but i envy how they touch down in my world and return to theirs. Condolences don't begin to fill the canyon of loss" (page 42).
After his death: "I continue to live with Bill, in an inner world where, from moment to moment, i’m conscious of his response to the day’s events, to how my life unfolds. He continues to guide me. I was his muse; now he is mine" (page 46).
*As I write this, I'm finding it hard to limit myself to just one example of a piece that "hit home" for me...*
She captures a lot of the nuances of the grief experience that are irrational, heart centered and spirit based very clearly and wholly.
Hence, when Lisa shifts from writing about her personal experience of grief, to one more of science and reflection on the neurology of loss I got tense. I was worried that this beautiful piece of writing was turning cold...rational...cerebral. But, in the end, it didn't at all - she was able to still be both - rational and irrational. Head and heart. Mystical and scientific. She still used her personal experience to illustrate her points, but she refers to many studies, outcomes, and sciencey things, like the neuroplasticity of the brain. The overall effect works. I was fascinated by the science that explains so much of what I experienced personally with grief. Everything from dreams to mindfulness to post-traumatic stress.
I've learnt over the years that I don't need proof of anything beyond my own personal experience when it comes to grief, but it really was reassuring to understand some of the biology and neurology behind grief.
“[G]rief is a manifestation of neurologic trauma, and is evidence of injury to brain regions that regulate emotions. Grieving is a healthy protective response. It’s an evolutionary adaptation to promote survival in the face of emotional trauma, one where the injury goes undetected since daily function is preserved.” (pg 142)
I found the end of the book very hopeful. She writes extensively on the science of emotional restoration and healing - from meditation to medication. She illustrates how a heightened nervous system post trauma can be tamed by periods of meditation, and warm companionship, where a healthy outcome is self-exploration and growth. She believes in both mindfulness as a way to immerse oneself in witnessing their grief, but also periods of distraction which give much needed rest.
"Since grief and loss cannot be avoided, how can we manage stress to increase our potential for growth and reduce the risk of maladaptation? Encourage the protective benefits of stress and avoid the harmful effects. Right balance of periods of distraction with periods of mindful meditation where we recall our difficulties." (page 100)
Do you know the phrase, "don't tell me how much you know, until I know how much you care"?
Well, by the end of this book I truly believe that Lisa Shulman doesn't only know about how the brain changes after a death, but she cares.
“As i walk the line between my own experience of bereavement and my background in neuroscience, I confess my “scientist hat” doesn't’ always fit quite as snugly as usual. Instead, this hat is cocked to one side, leaving room for special moments that defy explanation and bring comfort” pg 101.
In summary, this is another book I'd like to add to my shelf permanently (the copy I read was from the public library). It's a book I'd refer to again and again....and, of course, to tackle that bibliography :)
It's October, the month of Canadian Thanksgiving, and messages of gratitude are inescapable. I came across an article online that was titled "Go From Grumpy to Grateful in 5 seconds!!" It irritated me.
I'm irritated by the simplicity and instantaneous of it. Especially in October, when the bereaved are staring Thanksgiving in the face, wondering about how to navigate this "holiday" of gratitude, togetherness and abundance, when life has been irrevocably changed by something as uncontrollable and in-suppressible as death and grief.
Grumpy to grateful in 5 seconds
The premise is that changing your language from "I have to" to "I get to" creates more gratitude. For example, changing the statement "I have to go to work today," to "I get to go to work today" does make me feel more grateful for the fact that I have a job I love. I do find that it shifts my perspective in a positive way, and I'm not denying that this could be beneficial. But, with grief, I'm not so sure it's a helpful strategy. Especially in the early days and months after a loss.
I think back to the first Thanksgiving after Cam died. I could have said, "I get to go to our family dinner," but the only person I was looking for in that crowded room was him. I could have said, "I got to have him in my life" instead of "I have to live without him," but NO...at that time, the amount of instinctual protest I felt over his death screamed without end "I HAVE TO LIVE WITHOUT HIM IN MY LIFE." Gratefulness felt trite, empty and impossible.
In the past, wrote a blog post about this experience, and outlined some ways to make gratitude more accessible while grieving (you can read it here)...but this week, I was reminded by a grieving friend that sometimes, gratitude just isn't there. Period.
It got me thinking...
This divisive mindset of grumpy or grateful, or sad or happy, sorrow or joy, isn't helpful. It doesn't capture the complexity of human emotion, nor does it promote understanding the parts of ourselves that are so obviously calling out for attention and compassion.
What is wrong with feeling grumpy instead of grateful? I think it's an appropriate way to feel if someone you love has just died, and Thanksgiving is approaching. Just because it's October, doesn't mean your grief vanishes and is replaced by gratitude in 5 seconds!
If you find yourself unable to feel grateful this Thanksgiving, try releasing the struggle to feel something you don't feel. Don't engage in a discordant battle with yourself. What if you gave yourself permission to just feel what you feel?
Invite the sorrow to sit beside you at the table, so it doesn't have to struggle or compete for your attention. When there is no battle inside, you can listen to yourself and your needs with more clarity. What do you really need to feel more peace/balance/support/recognized/acknowledged/heard etcetera?
The integration of grief requires authentic expression of your experience. Especially the hard stuff. And, it also requires safe people and places for you to explore your grief and changed self. May your Thanksgiving plans include some of these people and places....
With time, no timeline, and from a place of true integration of your loss(es) and grief, gratefulness may spontaneously arise. And, because you'll have been practiced at paying attention to all aspects of life (the beauty and the pain), it's presence and your awareness of it will be even deeper.
I'd love to know your thoughts on this:
What is Thanksgiving like for you this year? And, what has gratitude/gratefulness been like in your experience of loss?
Wishing you moments of peace this weekend.