Anxiety- The Missing Stage of Grief

by Claire Bidwell Smith

  These days there are many online services that can help you create and complete these documents for a low cost, but there are also many attorneys who specialize in this area.

  Beyond some of these larger administrative documents, there is a lot of emotional work to consider. From what you want to happen to your favorite sweater to certain memories you want to make sure your loved one knows about, creating your own documents around these emotional components can be very soothing.

  You can create these however you would like, simply typing out lists or letters or writing things down in a notebook that can be kept with important documents. When a family is left to deconstruct the physical components of a loved one’s life, they are often left with a large amount of uncertainty about what to do with everything. Having some guidance from you can be enormously helpful.

  I fully acknowledge that doing these tasks can be initially anxiety provoking, but return to your deep breathing, mindfulness, and thought checking as a way to move through it, knowing ultimately that this work will assuage any anxiety.

  I’ve taken up the habit of meticulously recording events and data into baby books belonging to each of my daughters, and I also frequently write them letters that they can read when they are grown up. It sets me at ease to know that if I were to die before they are grown-ups, they will have a place to turn to for answers to questions I won’t be around to tell them in person.

  I think the bottom line is that we, as a culture, could prevent much of our anxiety about death by becoming better equipped to handle it—and to handle it not just in the moment when we are hit with a tragedy but well in advance.

  I mentioned earlier that I was pregnant with my first daughter when I was working in hospice and how I was struck by the realization that we do so much preparation around bringing a person into the world but very little when it comes to helping people exit. When I was pregnant, I attended birth classes, had a midwife, and enlisted the services of a birth doula, a person who serves as a companion during birth to assist the mother in providing physical and emotional support.

  In recent years, I’ve been heartened to see a rise in the services of death doulas, who do essentially the same thing. For this chapter, I consulted Los Angeles–based death doula Alua Arthur, to whom I frequently refer clients. Alua helps people who are dying put their affairs in order, working with them on whatever it is they need to in order to die peacefully.

  ALUA ARTHUR’S DEATH-BED TEST

  The question that I always start off asking is “What is it that you must do to get peace with yourself so that you may die peacefully?” The answers are as varied as our DNA—for everybody it’s really different. For some it’s to control finances, for others it’s about healing broken relationships. A lot of it is emotional. And I feel like that’s the threshold—once we work through that, we can get to the other things.

  I read a quote the other day by Atul Gawande that said that “the goal isn’t a good death, but a good life all the way through to the end.” What if we just applied the principle of good living through to the last moment or the last breath? A shift from fixing and making everything better, to surrender and acceptance of the fact that this life is brief, and at some point we’ve all got to take that big trip.

  I also think a big shift that could happen is that we could bring dying into every day. We could do this more with old people dying at home and families still being close-knit, seeing grandparents die and get old. Right now they go off to a nursing home and you see them once a month if you’re lucky, and then at some point they die and you go to a service, and then it’s over. So it creates far more fear than if it were actually present in our day-to-day lives. And children aren’t exposed to death as much anymore, which sets them up to not know how to deal with it later in life.

  With my clients I create a death care directive, essentially. I call it advance-planning, big picture. I look at their desires for life-support and decision-making and what do you want done with your body, your possessions, all the things we’ve accumulated in life. Are there things you care about? Can you give some type of guidance for the people left behind so they have a little more piece of mind?

  Inevitably, when we start talking about possessions people will say, “oh it doesn’t matter what happens.” But then they start thinking about the things that actually matter to them, and they say, “Well I’d hate it if all this just went to Goodwill.” Figuring these things out does give some peace.

  Another thing I really like about this document is that by the end of it there is something tangible, written by the person who died. So loved ones will still have a piece of them somehow, with very clear instructions.

  For people that are experiencing a lot of anxiety, I do death meditations. I sit them down and take them straight into the fire. And I also help them with the planning. Once people start getting practical about it I think it really does quell the anxiety.

  There’s also a lot of relationship components. For example, “I don’t feel clear about my relationship with my sister so what do I need to do today that would make it okay if I were on my death bed this evening?” Asking yourself am I comfortable with the way that everything is? If not, what do I need to do to fix it?

  I call it The Death Bed Test. I use it often for myself, when I’m in conflict or when there’s something I really feel like I need to get clear on. If I were on my deathbed how important it this thing to me? And the secondary thing is—that quote—“leave off ’til tomorrow only what you would be comfortable leaving undone.” Of all the myriad things on the to-do list, how many of those things are that important?

  One of the things that gives me a little peace is that most often right after someone dies their face doesn’t look like it’s in terror. They don’t look like they’re scared. Generally, they look pretty peaceful, and sometimes there’s even a slight smile. And so I personally think that dying itself isn’t very scary.

  Practically speaking, just start planning. Begin looking at your finances, start looking at your paperwork, start looking at all your stuff. Think about what kind of mess you’d leave if you were to drop off the planet tomorrow, and start handling those things. We have such a need for control as human beings, so I think if we can control a little bit of it, it reduces anxiety and makes things easier. I think it’s possible for everyone.

  One last thing that I think many of us worry about is how our loved ones will cope with our deaths. This is a common worry, especially among people who truly understand what it means to grieve.

  If this is something you are grappling with, take time to think about all the ideas presented in this chapter. Know that by tackling a lot of these preparations, you will be doing your very best to ease your loved one’s process of grief in the event of your death. Use the death-bed test: ask yourself, if you were on your death bed right this very minute, what is it you will have wished to put in place?

  Think about letters you can leave behind for your loved ones to read. Think about conversations you can have right this very minute. Take time to put your relationships in order, and strive to keep them that way. Talk to your loved ones in the near future about what it would be like if you were gone, and take the time to find out what it is that might be most helpful to them practically and emotionally after you are gone.

  I know that doing this work can be frightening. But all the research points to the fact that avoidance of a scary thing does not minimize it. In fact, the opposite is true. Facing your biggest fears is what will help you conquer them. Be patient with yourself as you move through this process. Read this chapter once, and let the ideas presented here settle for you. Then reread it again when necessary, with the knowledge that preparing for your own death might just be the very thing to set you at ease.

  A NXIETY C HECK-I N

  Let’s check in with your level of anxiety. While the last chapter focused specifically on facing your own death, at this point in reading you have also learned a great many things, both about
your particular grief process and a lot about how anxiety works and how to manage it.

  Rate your current anxiety level on a scale of 1–10 (with 10 being the highest).

  1 2 3 4 5 6 7 8 9 10

  Check the symptom boxes that currently apply:

  Panic attacks

  Insomnia

  Nausea

  Dizziness

  Heart racing/palpitating

  Obsessive worry

  Hypochondria

  Hopefully, by now you have noticed a big difference in your panic and anxiety levels. If you feel that you are continuing to struggle, then read back over particular chapters that resonated with you, or seek out the additional support of a therapist who can help you implement the tools you’re learning here.

  All of this work takes time, patience, and self-compassion. Remember that there is no quick fix to grief and anxiety but that small steps will truly help you begin to make great strides. Go easy on yourself, and continue putting in the effort to create space and healing for your work. You are not alone in your experience of loss and anxiety, but you can heal.

  12 | Death Is Not the End of Love

  Death is our friend, precisely because it brings us into absolute and passionate presence with all that is here, that is natural, that is love.

  —R AINER M ARIA R ILKE

  D EATH IS NOT THE END OF LOVE. I T IS THE BEGINNING OF A NEW relationship with yourself and with your loved one. But truly understanding this takes time. Grief is a journey upon which we all must embark in order to reach a place of peace and acceptance. And often that journey is frightening. Yet it is also full of transformation. When we face our greatest fears, we can begin to overcome them. Exploring death and loss in the ways in which this book suggests can help all of us to live broader, more compassionate, and more peaceful lives.

  While we may never get over the loss of a loved one, we can learn to live with the loss, and we can use the experience to find greater meaning and purpose in our lives. Grief is an extension of love and connection. You are sad because you have lost someone close to you. Grief makes us anxious because it illuminates all the uncertainty there is about living. But because you lost someone you love, it does not mean that you have to be sad forever, and it does not mean that you must live a life of fear.

  Thomas Attig writes, “We can continue to ‘have’ what we ‘lost,’ that is, a continuing, albeit transformed, love for the deceased. We have not truly lost our years of living with the deceased or our memories. Nor have we lost their influences, the inspirations, the values, and the meanings embodied in their lives. We can actively incorporate these into new patterns of living that include the transformed but abiding relationships with those we have cared about and loved.”

  If nothing else, I want you to take from this book that you are not alone in your feelings of grief and anxiety. So many of us have experienced this with you, and there are bountiful resources in the world, and within yourself, to help you cope with this experience and reach a place of transformation.

  I thought of every single one of my clients while I wrote this book. I recalled their stories of loss, their struggles to cope with the ensuing anxiety, and all the different things that helped them find peace. I designed this book with this process in mind, laying out each chapter so that you, the reader, may experience the same shifts they did. You picked up this book because you were anxious and unsure of how to cope with it. Hopefully, by now you have learned a great many tools that have enabled you to both decrease and manage your anxiety.

  For me, this process is also a deeply personal one. Learning how to live in the world and embrace my life following the loss of my parents was a long and painful journey. At the time these events occurred, I did not have the resources that are more readily available today. I often felt that I was making my way in the dark, but what I discovered along the way led me to the work I do today, reassuring and helping others who also feel alone in the dark depths of grief and anxiety.

  I continue to think of my mother and father every single day. Their deaths have impacted every aspect of my life. Yet in time, I have been able to see what a great gift grief has been to me, an unexpected companion that has taught me more about life and love than I ever imagined possible.

  I hope that this book has softened you in some way, that it has opened you up to the beauty of grief, for it is truly a reflection of love. Taking time to acknowledge that, and to allow yourself to simply immerse in the process of losing a loved one, is half of the work. As we’ve learned in these pages, pushing away your grief or your fear does not make it disappear.

  I want to remind you of your innate ability to cope in the face of tragedy. We are all capable of moving through incredible stress and sadness. Coping with it, finding strength and courage and resilience, does not mean you are letting go of your loved one. There are infinitely more ways to remain connected to, and honor, your person. But you must also remain connected to, and honor, yourself.

  Anxiety is a very real feeling. It can be overwhelming and debilitating. It can be frightening, and it can be sneaky. Throughout this book, though, I hope you have gleaned new insight into how anxiety works and how you can begin to manage it. There is no need to let your life be dominated by anxiety if you take a proactive approach to understanding it.

  Honor your story of loss. It is one that you will carry with you for the rest of your life. Let it shape and mold you. Look for the beauty contained within that story—the cherished relationship and love you shared with someone important. Write your story, tell your story, give it a home in the world, and treat it with reverence. It is yours to tell, yours to examine, and yours to share.

  Remember that holding on to parts of the story that don’t fit or don’t serve you will cause you to suffer. Make amends with your lost loved one, work through any residual anger, forgive them and forgive yourself for any transgressions you think you may have caused, and allow yourself to be the very real human you are. None of us gets through life without making mistakes or hurting people we love. But we can learn from those experiences and become better people as a result.

  Take charge of your life again, and acknowledge the changes that you have incurred as a result of your loss. The entire landscape of your world has likely changed, but that does not mean you have to stop living and thriving. Ask for help, and find strength in the stories of others who have had to rebuild in the face of loss. You are not alone.

  Find inspiration in your grief. Use your newfound knowledge of the fragility of life to enable you to live an even bigger and bolder life. Open yourself up to all the possibilities this world has to offer, and remember that your loved one would not want your life to get smaller as a result of their death. Instead, they would wish for you to grow and to flourish, to enjoy life as you once did when they were with you.

  Use the gift of words and language to explore your loss. Write about it in stories, write about it for yourself, write down your memories, and write letters to your person. Pour your words out onto the page, just as I have done here, and know that this is part of your healing. Using language as means of unearthing your grief and the love within you is one of the most powerful actions you can take.

  Think about your thoughts. Become aware of them. They are not who you are. They are thoughts, and they can be managed, changed, controlled, and transformed. Use your thoughts as a tool to change your perspective, to quell your anxiety, and ultimately to understand yourself on a deeper level. Doing this work will be a lifelong process that will serve you throughout all of your years.

  Embrace the present moment. Acknowledge that everything that is happening right now, in this moment, is exactly as it should be. Allow yourself to breathe and find the quiet that lies within you. Take a step back from your active mind, and learn to simply exist in the moment. This is one of the most profound routes to finding a lasting peace throughout your days.

  Remember that restoring a sense of connection to your loved one, however that looks, throug
h whatever means, is the key to living a life without your person physically by your side. They are not gone from your life. Delve into your spirituality and ask yourself what it is you really believe. Open up to the idea that death is not the end of your relationship with your loved one. Acknowledging this, and letting your relationship continue to evolve, will bring a sense of relief and will soften your heart and your fear.

  Step into the idea that you, too, will someday die. Embracing death will help you embrace life. Knowing that you have taken measures to prepare for your own death will allow you to release anxiety about leaving when the time comes. Preparing your loved ones for your eventual departure will help them, too. Planning for your death is really about planning for your life.

  I hope that you can see that doing all the work contained within this book will lead you to a more fulfilling, meaningful, and purposeful life. I cannot help but look back on all of my experiences of loss, even the most painful moments of it all, with anything but gratitude. Losing the people I loved most in the world and walking through the fire of grief broke me wide open. Grief taught me compassion. Anxiety taught me peace and presence. Loss taught me how to live and love. It can do the same for you.

  Acknowledgments

  B EING A THERAPIST HAS BEEN ONE OF THE GREATEST PRIVILEGES OF my life. I am honored to walk alongside so many people as they grieve and heal and come to new understandings of themselves and the world. This book would not be possible without each and every one of you. I am so incredibly grateful for your trust in me and for our time together.

  Thank you to my brilliant and tireless agent, Wendy Sherman, for her dedication in helping me realize my life’s work. You have been there for me every step of the way through all three of my books, and also through all of my big life changes as I wrote them. My love for you is like that of a daughter, and I am so proud to have your support. Thank you to my masterful editor Renee Sedliar for understanding my vision right away and then helping me see it through. And thank you to the whole team at Da Capo—I am so grateful for everyone who dedicates their days to putting books on the shelf.