To all my friends who double as family. You never cease to amaze me with your unending support, camaraderie, laughter, and tears. Caeli Wolfson Widger, Jenny Feldon and Jillian Lauren, Kelle Hampton, Sarah Jio, Jennifer Mack, Melissa Pope, Francesca McCaffery, Katie Devine, Hope Edelman, Mark Sarvas, and Ron Purdy. Thank you, thank you. I have no idea what I would do without you.
To my daughters, Veronica and Juliette. You have been my greatest teachers, and from you I continue to learn compassion, humility, creativity, and the knowledge that even the most broken hearts can heal many times over.
Last, to my husband, Mark, the least anxious person I have ever met. You have held me steady since the day we met. I told you about the idea for this book one night over a campfire in Asheville, North Carolina, and you helped me see it through from that very moment on. Thank you for always believing in me.
About the Author
Claire Bidwell Smith, LCPC, is a therapist specializing in grief and the author of three books of nonfiction: The Rules of Inheritance (2012), After This: When Life Is Over, Where Do We Go? (2015), and Anxiety: The Missing Stage of Grief (Da Capo, 2018).
Claire maintains an office in Los Angeles and works with clients around the globe. Throughout the year she leads workshops and retreats and speaks at events. Claire’s work has appeared on or in the New York Times, the Huffington Post, Salon.com, Slate, Chicago Public Radio, the Guardian, Psychology Today, Yoga Journal, and BlackBook Magazine.
Claire lives in Los Angeles with her children and husband. She deeply loves her work and seeks to further the conversation about death in order to help our culture reach a healthier understanding of how to move through grief.
www.clairebidwellsmith.com
@clairebidwellsmith
ALSO BY CLAIRE BIDWELL SMITH
The Rules of Inheritance
After This: When Life Is Over, Where Do We Go?
Praise for Claire Bidwell Smith:
“Claire Bidwell Smith takes us on a powerful journey of discovery. She asks the most important questions about life, love, death, and what it means to be human, and does so with equal measures of skepticism and a broken-open heart. … Reader, follow her. You’ll be so glad you did.”
—Dani Shapiro, author of Devotion and Still Writing, on After This
“Smith examines staggering losses with the clarity of vision of one on a mission.”
— Los Angeles Times, on The Rules of Inheritance
“Smith’s frankness connects with readers. She explores death and dying and opens up about stumbling through youth without the mooring of parents.”
— Chicago Tribune
“In After This, Bidwell Smith, an enchanting, knowledgeable, and candid guide, bravely describes her idiosyncratic journey through the various landscapes in which her grief has manifested. Her two callings—writing and helping others confront death—dovetail beautifully.”
— Los Angeles Review of Books
“Smith’s voice is so assured, so curious, that it’s impossible not to want to follow her wherever she might lead us, from organized religion to shamanism to science.”
—SFGate.com, on After This
Resources
While there are a great many grief resources available today, these are some of my favorites and the ones I feel best complement the work this book has to offer.
ONLINE GRIEF COMMUNITIES AND WORKSHOPS
Deathoverdinner.org
Dinnerparty.org
Grief.com
Griefnet.org
Griefshare.org
Modernloss.com
Onlinegriefsupport.com
GRIEF BOOKS
A to Z Healing Toolbox: A Practical Guide for Navigating Grief and Trauma with Intention , by Susan Hannifin-MacNab
Bearing the Unbearable , by Joanne Cacciatore
How We Grieve: Relearning the World , by Thomas Attig
It’s OK That You’re Not OK , by Megan Devine
Modern Loss: Candid Conversations About Grief , by Rebecca Soffer and Gabrielle Birkner
On Death and Dying , by Elisabeth Kübler-Ross and David Kessler
WRITING RESOURCES
Braving the Fire: A Guide to Writing About Grief and Loss , by Jessica Handler
Creativenonfiction.org—online memoir classes
Refugeingrief.com—online grief-writing courses
COGNITIVE BEHAVIORAL RESOURCES
The Anxiety & Worry Workbook , by Aaron T. Beck and David A. Clark
Beckinstitute.org
Dr. Pierce—drphilippierce.com
MEDITATION/MINDFULNESS
Artofliving.org
Full Catastrophe Living , by Jon Kabat-Zinn
Headspace.com
Loving What Is: Four Questions That Can Change Your Life , by Byron Katie
Mindful.org
The Mindfulness and Acceptance Workbook for Anxiety , by John P. Forsyth and George H. Eifert
The Miracle of Mindfulness , by Thich Nhat Hanh
Radical Acceptance , by Tara Brach
Real Happiness: The Power of Meditation , by Sharon Salzberg
Wherever You Go, There You Are , by Jon Kabat-Zinn
Wildmind.org
DEATH PLANNING
Alua Arthur—goingwithgrace.com
Amy Pickard’s Good to Go! —goodtogopeace.org
Caringinfo.com—find individual states’ advance-care directives
Departingdecisions.com
How to Die: A Field Guide , by Dr. B.J. Miller and Shoshana Berger
International End of Life Doula Association—inelda.org
National Hospice and Palliative Care Organization—nhpco.org
Zenhospice.org
LOSS OF PARENT
Fatherless Daughters Project , by Denna Babul and Karin Luise
Motherless Daughters , by Hope Edelman
Parentless Parents , by Allison Gilbert
LOSS OF SPOUSE OR PARTNER
Sisterhoodofwidows.com
Soaringspirits.org
Thekitchenwidow.com
LOSS OF A CHILD
Compassionatefriends.org
Copefoundation.org
Glowinthewoods.com
Missfoundation.org
CHILDREN’S GRIEF
Childrengrieve.org
Dougy.org
Foundationforgrievingchildren.org
MILITARY LOSS
TAPS.org
SUICIDE LOSS
Allianceofhope.org
References
CHAPTER 1
The first thing to know : https://adaa.org/about-adaa/press-room/facts-statistics#.
most common health issue on college campuses : https://sites.psu.edu/ccmh/files/2017/01/2016-Annual-Report-FINAL_2016_01_09-1gc2hj6.pdf.
data from the National Institute of Mental Health : https://www.nimh.nih.gov/news/science-news/2010/national-survey-confirms-that-youth-are-disproportionately-affected-by-mental-disorders.shtml.
CHAPTER 2
Attig, Thomas. How We Grieve: Relearning the World . New York: Oxford University Press, 2011.
Kübler-Ross, Elisabeth, and David Kessler. On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss . New York: Scribner, 2014.
Worden, J. William. Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner . New York: Springer, 2009.
CHAPTER 5
Hone, Lucy. Resilient Grieving: Finding Strength and Embracing Life After a Loss That Changes Everything . New York: Experiment, 2017.
Sandberg, Sheryl, and Adam M. Grant. Option B: Facing Adversity, Building Resilience, and Finding Joy . New York: Alfred A. Knopf, 2017.
CHAPTER 7
Handler, Jessica. Braving the Fire: A Guide to Writing About Grief and Loss . New York: St. Martins Griffin, 2013.
CHAPTER 8
Clark, David A., and Aaron T. Beck. The Anxiety and Worry Workbook: The Cognitive Behavioral Solution . New York: Guilford Press, 2012.
Katie, Byron, and
Stephen Mitchell. Loving What Is: Four Questions That Can Change Your Life . New York, 2003.
CHAPTER 9
Kabat-Zinn, Jon. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness . New York: Bantam Books, 2013.
. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life . New York: Hachette Books, 2014.
CHAPTER 10
Gilbert, Allison. Parentless Parents: How the Loss of Our Mothers and Fathers Impacts the Way We Raise Our Children . New York: Hyperion, 2011.
. Passed and Present: Keeping Memories of Loved Ones Alive . Berkeley, CA: Seal Press, 2016.
Index
A to Z Healing Toolbox: A Practical Guide for Navigating Grief and Trauma with Intention (Hannifin-MacNab), 111–112
acceptance
cultivating mindfulness, 196
five-stage grief model, 45–47, 50–51
resilient grieving, 120–121
Worden’s grief model, 53
addiction to anxiety, 21–22
adjustments after loss, 28, 53
advance directive, 228–229
After This: When Life Is Over, Where Do We Go (Smith), 203
afterlife
exploring the during grieving process, 130, 143, 202–203, 206–208
importance in a grieving process, 199–200
Jewish perspective on, 212
open discussion about, 204–205
See also belief systems and spirituality
alcohol abuse, 6–7
amends
exercises for, 101–104
forgiveness over death to illness, 92–93
grief and guilt, 85–86, 89–90
letter writing, 101–102, 142
taking a personal inventory, 134
amygdala, 189
anger
analyzing underlying anxiety, 127–128
components of grief, 57
anger (continued)
disillusionment as manifestation of, 131–132
exploring spirituality, 209–211
five-stage grief model, 45–46, 50–52
guilt accompanying, 88–89
meditation helping normalize emotions, 187
over loved ones’ lack of death planning, 225–226
the persistence of a relationship after death, 200–201
reconnecting with the loved one, 204
of young widows with children, 111
anniversaries, 76, 214–217
antisocial behavior: components of grief, 57–58
anxiety
anticipating death to illness, 113–114
assessing grief-related anxiety, 25–27
balancing grief and freedom, 125–126
the benefits of learning to manage, 237–238
catastrophic thinking, 167–168
components of grief, 57
consequences of suppressing, 49–50
defining and describing, 17–18
facing death, 221–227
fear of, 169–173
finding the triggers, 33–35
in the five-stage model of grief, 50
guilt over failure to anticipate death, 93
its place within grief, 48–52
letter writing alleviating, 142–143
mindfulness alleviating, 183
normalizing, 27–29
physical, behavioral, and cognitive symptoms, 164–166
purpose and causes, 19–22
resilient grieving helping to relieve, 110
returning to normalized thinking, 170–172
statistics on, 17–19
symptoms of, 22–27
unhealthy relationships after a loss, 134–137
See also retraining your brain
The Anxiety and Worry Workbook (Beck), 162
Arthur, Alua, 230–232
atonement. See amends
attachment, 129, 136
Attig, Thomas, 47, 54–55, 112–113, 236
avoidant attachment, 129
bargaining: five-stage grief model, 45–47, 50–51
Beck, Aaron T., 162
Beginner’s Mind, 195
behavioral symptoms of anxiety, 165
being present. See mindfulness
belief systems and spirituality
Attig’s grief model, 54
dealing with anger over loss, 209–211
finding meaning in anniversaries and holidays, 214
incorporating into daily practice, 207
letter writing and, 143
letting go of guilt, 93–94, 98–100
the power of rituals in connecting to loved ones, 212–214
psychic mediums, 211–212
reconnecting to the loved one, 201–204, 218
self-inquiry method for analyzing, 176–179
talking openly about death, 204–206
thoughts of an afterlife, 206–207
blogging, 144–145
brain. See retraining your brain
Braving the Fire: A Guide to Writing about Grief and Loss (Handler), 148–149
breathing techniques, 174–176
Brown, Brené, 85 (quote)
calm breathing: overcoming panic attacks, 30–33
catastrophic thinking, 167–168, 172
change, resisting and leaning into, 137–138
children
creating threads of connection to loved ones, 217–218
letters from parents to, 154–155
parenting a grieving child, 131
as reminder of the loss of a parent, 202–203
ritualizing loved ones, 215
routines helping with resilient grieving, 116
young widows coping with loss, 110–114, 116–119, 131–133, 136–137
Chodron, Pema, 107 (quote)
closure, the myth of, 92
codependency, 136
cognitive behavioral therapy, 162–166
awareness of worrying, 173–175
catastrophic thinking, 167–168
fear of anxiety, 169–173
returning to normalized thinking, 170–173
cognitive symptoms of anxiety, 166
compassion
letter writing, 102, 143–144, 155, 158
making meaning in grief, 120
during meditation, 184, 189–192, 194–195
personal growth stemming from grief, 147
complicated grief, 63
connecting to the loved one, 200
grief as an extension of connection, 235–236
the power of rituals in, 212–214
Worden’s grief model, 53
See also letters, writing; writing
control, need for, 170, 184–185, 187
coping strategies
catastrophic thinking, 167–168
fear of panic attacks, 169–170
panic attacks, 30–33
stories as, 78–79
cost-benefit analysis of anxious thoughts, 172
crazy, feelings of being, 23, 44, 56–57, 165
crying: components of grief, 56
cultural expressions of grief, 45, 62–63
daily journaling, the importance of, 150–152
death and loss
affect on grief, 59–60
anxiety resulting from, 14–15
bereavement counseling, 8–9
bodily responses to physical threat and, 32–33
fear-response system, 21, 24–25
guilt as an accompaniment to, 85–87
learning how to plan for and face, 10–11
long-term grief and anxiety, 12–13
medicalization of, 48–49
as a new relationship with your loved ones, 235–236
of parents, 4–5, 7–8, 37–38, 59–60, 69
personal thoughts of, 130
processing loss to illness, 90–91
relationship between grief and, 48–52
saying good-bye to the loved one, 102
sto
rytelling, 80
talking openly about, 204–206
Death Bed Test, 231–232
death care directive, 231–232
death doulas, 230–232
death planning
alleviating fear and anxiety through, 221–227
death doulas, 230–232
Good to Go! , 225–227
living wills/advance directives, and living trusts, 228–229
preparing your loved ones for your death, 232–233
questions and checklist, 227–228
denial
failing to anticipate death from illness, 91–93
five-stage grief model, 45–47, 50–51
resulting from examining past experiences, 73–74
of your own impending death, 77
depression, 7–8
components of grief, 57–58
connection to intensity of love, 111–112
five-stage grief model, 45–47, 50–52
making a place in your life for, 49–50
signs of serious depression, 58
statistics on, 18–19
Diana, Our Mother: Her Life and Legacy (documentary), 93
diaphragmatic breathing, 174–176
Didion, Joan, 67 (quote)
distractions, resilient grieving and, 118–119
Edelman, Hope, 68–71, 76–79, 176–177
emotional fidelity, 44–45
emotional intimacy, 127, 129–130
emotions
acceptance of loss, 52
cognitive behavioral therapy, 162–166
components of grief, 55–59
meditation helping normalize, 185–188
physical and emotional symptoms of grief, 44
processing a loss, 28–29
resilient grieving, 122
response to constant thoughts, 181–182
evidence, anxious thoughts and, 171–172
exercise, resilient grieving and, 118
externalizing your story, 72
family
Anxiety- The Missing Stage of Grief Page 22