good evening and welcome to this special mental health edition of doctors on call I'm Mary Morehouse a psychotherapist with Insight Counseling of Duluth and I will be your host for our program tonight on Grief and lost the holiday season can be an especially difficult time for those who have suffered a loss our program is here to answer your questions about mental health issues that may affect you your family or friends please call or email your questions and we will do our best to address them the telephone number is an email address can be found at the bottom of your screen our expert guests this evening are Dr Deb summerroth is the founder and owner of the Silas Center for grief and loss in Duluth and is a psychotherapist with multiple professional accreditations and Regina Dixon is a licensed psychologist and a grief therapist with essential help in Duluth our phone and email questions are being received this evening by members of the dwdse staff who will bring them to me here in the studio now let's begin our discussion of grief and loss hi Dr Deb and Gina thank you so much for coming here tonight I'd first like to just start off so our viewers can know a little bit about each one of you and what and and your practice so Dr Deb if you could start out tell us a little bit about what you do in your practice please so um I have my um Sala Center for grief and loss and I'm a therapist and I see primarily clients with grief loss and Trauma okay and I also do some teaching at junk faculty at Winona State and I teach a class on Grief loss and Trauma there in addition to I teach some some local courses on understanding your grief I have a support group that is twice a month on suicide bereavement support group as well and I serve on the Minnesota Department of Health suicide post Mansion task force okay wonderful so a little bit about me yeah thank you thank you so much and Gina thank you for having me I serve as the program manager with Essentia Health grief support services and in that role I provide grief counseling along with a great team and we also offer free support groups for grieving children teens and adults and provide Outreach and education and other Supportive Services okay wonderful thank you so much so if we could just start by talking about the holidays and grief and what you are seeing in your practice Dr Deb can you start with that it's a big question yeah it is it is however um where some therapists at during the holidays maybe they are seeing less clients with grief and loss I believe the the amount of clients actually increases um so I'm I see people with traumatic grief suicide loss child loss and obviously other losses and um and right now clients are seeking to get through the holidays to enter into a new year and challenges and struggles surrounding that okay okay and Gina what are you seeing with with grief and loss and the holidays again big question well I Echo what what Deb said that the anticipation of holidays or other special days are often worse than getting through the day itself and very often people will share that the second or third set of holidays were actually harder than the first because the first set of holidays people might have a lot of support from family or friends and numbness kind of carries you through and as time passes sometimes you know people don't always recognize the ongoing nature of grief and it can kind of side swipe them and so it's not unusual for maybe people who haven't come in for a while to come back around the holidays and be feeling a lot of anxiety as we're heading into this season into the season yeah and that brings me to how can we how can we support people who are going through grief and loss right you know during this holiday season that we have a loved one I think we all have no people who are are experiencing maybe a more of an acute loss right now are going through an especially difficult time what's what's the best way for for people to support those who are going through grief and loss Dr Deb I'm sorry that's a great question uh Mary um I think people out are a loss when uh to wonder and they wonder how to support but I think some some key pieces are supporting their holiday choices would be one piece regarding what they would opt to do for the holidays if they will participate in the in the traditional holidays so inviting them but not to be allowing them to have Choice okay that's a big part for supportive I also think you they can send a thoughtful card um Christmas cards if we would look at the Christian tradition of Christmas cards can be very difficult people share Family Photos Etc so maybe you opt to send a thoughtful card that is different and that can be very supportive as well I have I wrote down because I thought of today about the idea of listening without minimizing and so being very supportive not judging giving it or giving advice but that idea of minimizing I think is really can be very powerful to not do that okay Gina your thoughts on how how to support yeah I would say most importantly what not to do is to avoid The Grieving person oftentimes people feel like uh Typhoid Mary you know they're walking down the uh the aisle at the grocery store and feel people walking the other way because they're so uncomfortable or afraid that they're going to make the person cry or afraid of saying the wrong thing so you know to Deb's point of reaching out being proactive and most grieving people appreciate when you share stories of of the person and use their name but meet the person where they're at and ask you know how can I be most supportive invite to events but then not to be offended if the moment comes and the person's just not able to participate in whatever they had the best of intentions of being a part of because grief is messy and it comes and goes in waves and people can't always predict what they're going to need a week from now let alone five minutes from now yeah absolutely and Dr Deb maybe you could take this post-traumatic growth could you can you describe what that is um so I see post-traumatic growth as a somewhat of a reconciliation so to speak of of their grief experience um and post-traumatic growth is doesn't necessarily mean it's after someone has grieved for a more and for a long period of time post-traumatic growth can occur in small small ways small bite-sized pieces all along the way um joining a support group could be considered post-traumatic growth someone um writing an article journaling lots of aspects that provide growth is how I would Envision that okay do you have anything to add to that Gina yeah I would just say that process of integrating our losses and creating a new relationship with the the person who died and I'm careful that while you know we have many wonderful volunteers that co-facilitate our groups are are giving back as a result of what they have received from other group members that would certainly be an example of post-traumatic growth but I also caution people not to you know pressure that or put that expectation on others because you know it's a matter of survival for many many Grievers and so this idea that there's a silver lining or something good is going to come out I think sometimes that's how people interpret that and I think that's just unfair to grieving people so and I think hope is a powerful thing and that's part of the reason why I support groups can be so healing is that people who are attending have empathy for each other's pain I I also co-facilitate an adult Survivor of suicide support group and and very often there's there's really um ah some beautiful interchange between group members that are able to validate each other's losses but also share this is what got me through that first set of holidays not in a way of giving advice but just of laying out the buffet of choices yeah it's good to know sometimes for the for the the beauty of support groups is to know that you're not alone because I think grief especially during the holidays can feel very isolating and very very very alone which um that kind of brings me you know kind of looking at this kind of more of this on a real on a bigger scale This Global pandemic that we have been through for the last two and a half years almost coming up on three years here and just really seeing this kind of a collective loss um again I have a I have a daughter who graduated with the class of 2020 in high school and she she's a junior in college now and she talked to me about it this week so it's not it it's it's grief and loss is not just the the loss of of a loved one but it can also be the loss of um through divorce the loss of this nuclear family that that we we had the loss of of so many Milestones that we weren't able to kind of get through and the in these last few years and how kind of my mother-in-law died during the during the pandemic and we waited 15 months before we were able to have a service um and so there were all those kind of more I guess more pandemic related you know Gina could you kind of see what you you know what you're seeing with that I I work in a metal Medical Center and I can certainly speak to the wear and tear uh that uh the pandemic has had on on medical providers with wave after wave of um up surges of covid and and also just caring for people coming in with with other illnesses and I don't think any of us expected covid to impact us the way and the way it has and such an ongoing way and so there has really been a loss of our our old world as we we knew it and so my my encouragement to people is to really Pace themselves you know we were talking about grief coming in waves and that's certainly true with this pandemic that it has impacted relationships in a multitude of ways As We Gather whether it's for funerals or weddings or other things and and just to be particularly gentle that we never know what somebody else is what what road they're walking on and so we may have really different appearances or different beliefs but but try to be respectful because we see the tip of the iceberg usually of people's lives and whether we're passing someone in the grocery store or whatever just to recognize many people have experienced a multitude of losses during this pandemic and continue to do so absolutely if I could just add to that Mary I was thinking of as you talked about a family member's death the idea of ritual is so so vital in in our world the ritual of graduation the ritual of weddings but the ritual of funeral of the idea of of progressing with your own mourning and being denied yeah or the ritual a funeral and I think of that during this piece so I would encourage folks if they did not or were unable to have ritual during this time frame that it is never too late to do ritual and so if somebody didn't have a funeral that maybe it's going to look differently now and so that idea of how can you now integrate that into your life now to be able to have that that full experience and so I do think that's the challenge with one of the aspects with covert that seems very obvious but we don't name it as ritual on how important that is within us as a culture as we have milestones and and then we miss those yeah it's been hard to miss those Milestones these last few years yeah go ahead and I was going to add to that when you were talking about the impact of rituals related to bereavement but also visitor restrictions in the hospital and you know how many families were not able to be with loved ones while they were in the hospital and how that really complicates grief too that people can have delayed grief or you know complicated grief because of what it could have showed us or not having those opportunities to say some of the things that they would have otherwise had and again that it's never too late and very often within therapy that's part of what we do is Provide support for you know know going back and meeting some of those really important needs that just weren't able to be met at the time yeah it's so true all right so we have a question here how do you handle friends and family who feel it has been long enough since my partner passed and I should be over it by now can you take that first that's a hard one that's a hard one um in our culture we we are in a society that places time limits on Grief and the idea that that you know the magic one year or whatever that would be that these time limits are placed on it is to you know maybe have conversations with with with the person educate them and so those of us who are Grievers which most of us are in some way shape or form Grievers we we end up being the Educators and letting people know I also think offer them Grace as well because they may not understand and it isn't their significant other who has died but and so to have a more understanding but I also think it's education it's helping them understand where I'm at I think of so often I've shared with clients Dr Alan wolfeld has the mourner's Bill of Rights and and I will you know tell clients or in the the support group that I facilitate you know posted on you know families refrigerator and it reminds that you know grief is those internal pieces and mourning is that external aspect and that morning continues and support is required like Gina was saying that you know two three years down the road we're in a different development phase the fondest we've thought out a bit and now there's new realization that our world is not the same yeah absolutely so World assumptions are a big part that others want to speed you along and is it out of their own discomfort or because we want the old you back and we are changed beings by grief and so I think that's the power of it but so education is a big part awesome subtle ways maybe subtle I like the Bill of Rights that sounds great all right um Gina um from from a viewer my mom died one year ago do most people go to counseling alone or with their family and how long does the grieving process last that really speaks to our last conversation very much so yeah and I'm so glad we're having this conversation and I'm so glad that uh that this viewer shared that question because there is a lot of misinformation and a misconception that somehow we get through that first anniversary and we're magically having closure and it just doesn't work that way uh that that grief does in fact come in waves and uh it's it's been decades since my father died by Suicide and there are moments that are still Bittersweet around the holidays in particular and so to um just to know um that that you're not alone if it feels like it's taking longer than you could ever imagine and remind me the other part of that yes absolutely um so do most people go to counseling alone or with their family I I think it's really um a mixed bag I would say the majority of people come in individually and sometimes that can be because different family members need different things and having your own space to be heard and to be able to share without any kind of judgment can really be a tremendous gift I would say particularly families with young children it can be really helpful for a parent to have their own time to do some of their grieving but then come together and meet as a family with their their child's therapist to better understand their needs and how they can grieve together and create ritual together and so that's how I would answer that question in my experience okay great great all right Dr Deb will go back to you can one grieve for their own losses during childhood say that again can can someone grieve for their own losses during childhood can they grieve for their own losses during childhood oh absolutely yeah absolutely yes so I think of um and and Gina works or has worked a lot with children and actually has done a beautiful class that I recall that she had offered in the past with children going through grief and I think of the power of of allowing children to grieve and it's going to be very different than adults so children can be so impromptu with with you know I think of how they will just bring up the person's name and they will learn quickly if that's not being allowed in a household and so I I think of that with children to allow them to include them in conversations maybe in part of some processes whatever that might look like and then I do believe then as people get older that you know grief isn't just resolved at age eight or age 11 or 15. as we developmentally go through through phases spaces in our own lives things arise in US and this uh the next question um thank you for that um Gina so um it's along the same vein where do kids fit into the family grieving and I think that that's so um uh you know I I had a a cousin who died a year and a year and a half ago now and you know the the the children of of him were at very different stages of grief the high school college age and then and then the mom so so again those were older but how do they fit into the into the um into kind of the whole family grieving with everyone really grieving at their own pace how how do you how does one handle that uh particularly young children tend to have shorter grief spans where as you say they might be really spontaneous with expressing something and then want to go play with Legos and so I think it's important to meet children where they're at and provide opportunity for support and also always offer choices I would also say something about secondary losses I mentioned that I was in fourth grade when when my father died by Suicide and in addition to the the physical loss of my father there were all these secondary losses we had to move to a new house and a new school and I couldn't see my friends anymore we left pets behind my mom went from being a stay-at-home mom that was pretty with it to a pretty traumatized mom that had to go back to work and and so to be aware not just for kids but for adults that secondary losses can really be ongoing and it's important to acknowledge those and as we're able to support people and navigating those secondary losses but particularly for children I would say the loss of the old normal you know how how things used to be at home we used to sit around the table and have dinner and now mom's too sad for that and so as we can name those secondary losses it helps to navigate them together as a family if it's safe to do that and in some families it's not safe to do that for a variety of reasons maybe there's drugs or alcohol in the family or or other stressors and so sometimes you know as the other caller had said that that support doesn't happen until months decades later and that it's never too late to do our work for childhood losses that's very good of course of course is very good um so we're uh just just real quickly we we talked a little bit earlier um about the stages of grief that we all know and and I know Dr W said you prefer phases to stages and sometimes I know kind of the end goal is I want to get to that acceptance piece so just real quickly can you just kind of go through kind of your philosophy of that well I'll use um Dr Alan wolfeld who's the center for loss and life transition he has what's called a companioning model and it's really a beautiful one for peer support it's what I use in the support group so people as they begin to support one another and go off in community here's our and I his he calls them needs of mourning six needs of mourning so his first when he talks about acknowledging the reality and then he goes into a break embracing the pain of the loss remembering the person who died developing a new self-identity and then searching for meaning and that idea of reconciliation is important not so much acceptance but reconciliation that's wonderful what a wonderful way to end thank you so much Dr Deb I want to thank our panelists Dr Deb simaroth and Gina Dixon for their time and expertise tonight and for those of you who called in or emailed questions doctors on call will be off the next two Thursdays for our holiday break please join Mary Owen for our next show on Thursday January 5th for a program on indigenous Health when her guest will be Dr Arnie vanio Roxanne de lill and Ricky Defoe I'm Mary Morehouse for the guests and crew here at wdse thank you for watching and happy holidays foreign