Maybe the most powerful realization for me was that Joey is not only still alive, but he is truly immersed in love. He is happy, alive and well, not broken or defeated. I can’t feel bad for him, I know he’s fine. I do feel bad for his siblings, for myself at times, but especially for his mother and his children, as we all miss him terribly. But no more pity for Joey. He died doing what he loved and continues to live with purpose in the beyond, or at least that’s how I have construed it in my mind. As far as missing him, I know that’s normal. I still miss my father, and that’s been, s**t, twenty-seven years now. But it’s not a crushing depression, just a sadness that reminds me of how much I loved someone who is no longer here… It’s funny, but just having Joey ask me to step up and be there for his family helps to provide me with a purpose that wasn’t there before the imagery. Rather than believing that all is lost, now that my Joey is dead, I know that I am charged with a mission to be the best grandfather I can be to his kids. I don’t know, it just feels like a purpose that I cannot ignore. What I like best about it is the sense that instead of feeling powerless as I did, I now feel challenged with a type of mission where I need to step in for my dear son, because he can’t do it for himself. I find myself feeling grateful to God for having important things to do that honor God and honor Joey.
Joe’s reframe consists of the new-found ability to accept that in an imperfect world, parents can and often do lose children through no fault of their own. Secondly, Joey died because he fell thousands of feet to the ground, not because God is spiteful, Joey was bad, or his parents were being punished for some reason. I asked Joe, a Catholic Christian, to consider the scripture where Jesus’ disciples asked, “And his disciples asked him, saying, Master, who did sin, this man, or his parents, that he was born blind?” Jesus responded, “Neither hath this man sinned, nor his parents: but that the works of God should be made manifest in him.” (John 9:2–3)
Again, it is imperative to reframe the tragedy by finding meaning in Joey’s death. Part of that meaning became Joe’s need to be a better father than he had ever been before and an even more loving husband, as well as a newfound passion to be a male role model and father figure for his grandchildren. The reframe was a challenge to honor God and Joey by living his life in pursuit of being worthy of that calling.
What about the Atheist?
I can hear some of you asking: What about the atheist? Will these techniques work effectively if there is no God, and no world beyond this one? Rochelle was a woman in her late seventies who was accomplished, humorous, loving, and very straightforward. An ethnically Jewish woman with no belief in a higher power, she lost Rachel, her forty-five-year-old daughter to cancer. Rachel was, at least in Rochelle’s eyes, the best person on the planet. She described her as a brilliant, kind, salt of the earth kind of child, who made every life she touched better. Losing her was the single toughest thing Rochelle had to face in almost eight decades of life.
Naturally, I told her about guided imagery and the need to gain some closure, but Rochelle refused to use this technique to allow Rachel to say that she was alive and happy. According to Rochelle, “When you die, you die, and there is no more.”
Nevertheless, imagery was indeed helpful, in that both women were able to say things that Rochelle needed to say and hear (from Rachel). And despite the lack of potential for a later meeting date, Rochelle was afforded an opportunity to hear Rachel say, “Even though I am gone, mom, and I’m not returning, I still want you to be happy and I want you to continue living a good life without me.” Divine intervention or a belief in an afterlife is not required to trust that the person you loved who is no longer here still wants you, the bereaved, to be happy as they did in life.
Despite the belief that she was saying goodbye to her daughter forever, Rochelle benefited from this action. She reframed Rachel’s passing by emphasizing that her daughter had enjoyed a well-lived and worthwhile life. She also recognized that no one would have wanted Rachel to continue living in pain as her body was being consumed by cancer. For Rochelle, the adage that it was far better for her to have loved and lost Rachel than to never have loved her at all was certainly true, and this helped her to say goodbye. From all indications, Rochelle’s treatment proved to be very healing, as she returned to therapy shortly thereafter when her husband died to work toward releasing him as well.
What about Nate?
Nate, our love-sick martyr carrying an eternal cross for Angela, was stuck in a fantasy due to an unwillingness to accept reality (avoidance), or perhaps an avoidance of painful emotions like disappointment, rejection, and loneliness. What can he do to reframe his loss? Essentially, he needs to tell himself the truth:
My fantasy version of Angela, is just that, a fantasy. She never thought of us as more than friends, so the “lovers” relationship existed only in my mind and is no more a reciprocal relationship than the one I have with Michelle Pfeiffer or Cindy Crawford. So why do I keep hanging on to Angela? Because I like the high of thinking we had something special, when really, I was infatuated but had only found a new friend, nothing more. I can release her and put energy into meeting other women through friends and online dating and be more realistic in my pursuits in terms of age and level of attraction. Everyone tells me that a beautiful woman on the inside is a far better choice than a beauty queen, anyway. Most importantly, I want to be with someone who loves me for me, someone with whom I share values in common values, and someone who is truly my best friend. Maybe it’s time to write a goodbye to Angela and thank her for the many life lessons I’ve allowed her to teach me.
The Purpose of the Reframe
Earlier in the book, I spoke about the stress response and how detrimental it can be if left in the “on” position. These reframes move your brain from the intensely stressful “it’s horrible” position to the less stressful “it’s okay.” By believing it’s okay, you can turn off the stress response. Once the stress response is finally off, you can release the pain in the past and live in the present with purpose and meaning. By turning off the stress response, you can finally refill your emotional energy and use that energy in more effective ways.
You probably were aware that the individuals profiled in this chapter had little to no responsibility for the traumas that threatened to destroy their lives. However, this is not always the case. Sometimes the one holding onto the pain is also the one who has culpability in having caused the pain. In the next chapter we will explore how to reframe if you carry some responsibility for what happened.
Chapter Eight
Moral injury: What If You Really Are Guilty?
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“You’re only as sick as your secrets.”
—AA Big Book
Moral Injury: What If You Really Are Guilty?
You have now read several stories of how innocent, loving parents often assume toxic guilt when their children die in accidents. You now understand how and why you may remain in guilt because it protects you against the need to accept reality and say goodbye to your loved one. Removing the protective guilt allows you to deal with the real issue—the incredible sadness from the loss of that loved one. And as you are able say goodbye to the beloved, you can permanently release the guilt. Once again, please note that the guilt was misplaced anyway. It was undeserved, because you did nothing wrong in the first place. Your loved one died through no fault of your own.
But what if there really was some culpability on your part? What if you did contribute to or cause someone’s death? Cheat someone or steal from them? Commit infidelity? Neglect or abuse your children? In other words, what if you really did do something wrong that caused a deleterious outcome for someone? Perhaps needless to say, making mistakes is a significant part of the human journey. Mistakes and poor choices infiltrate even the healthiest and most successful of lives. Without making terrible mistakes, we would never learn the great lessons of life on Earth.
The Concept of
Moral Injury
As you might imagine, psychologists treat many, many people who have been violated by others, and you have read many of these accounts already. But sometimes, the person we see is the culprit—the one who has perpetrated the pain. For the purposes of this chapter, let’s focus on several true stories of people causing or contributing to the death of others. Sometimes these others were people they knew and loved very much; sometimes the victims were complete strangers to them. I will also include different types of perpetrators, including the now recovered alcoholic or abusive parents, who left many an invisible scar on now resentful adult children. I will share the real-life process and outcome for each of these people and then some psychological and religious input on self-forgiveness when it really was your fault. Please allow me to share the backstory first and then the healing process later in the chapter.
Ruth’s Story
Ruth was on vacation, enjoying her wonderful family, when suddenly she took a very hard fall, sustaining a back and neck injury in the beginning of a series of disasters. The major foundations of her life (family relationships, health, financial security, spirituality) began to fall like dominos as one disaster after another ensued, culminating in the following tragedy:
In an effort to treat her significant physical and emotional pain, Ruth relied on medications. Her regimen included a mix of chemicals that not only made her pain tolerable but created a debilitating drowsiness that put Ruth in bed for hours each day—something that she had never experienced before. One day, Ruth and her husband Ira were babysitting Jessie, their three-year-old granddaughter. Ruth was suffering more than usual and called to Ira, who was cleaning the swimming pool at the time. He heard her call, came upstairs to see what she needed, and inadvertently left the gate to the pool unlocked. Jesse found that opening and drowned.
Losing a three-year-old is a devastating blow for even the healthiest of families. But to lose a child due to a simple mistake like failing to latch a gate (because you were responding to the call of an ailing wife) is even more crippling. Imagine having to tell your daughter what had happened. Ironically, perhaps, it was Ruth and not Ira who absorbed the lion’s share of the guilt for Jessie’s death. Piggybacked on top of the loss of her health, her job, and her financial stability, now she felt a combination of guilt for having called for Ira (and for being bedbound and nonfunctioning) and a resentment toward him for having left the latch unlocked. Marital difficulties ensued, and by the time I met Ruth, she was suicidal, depressed, and in a state of self-loathing. But was it necessary for her to assume responsibility for Jesse’s death to say goodbye to her? We’ll return to Ruth later in the chapter.
Holly’s Story
Holly was thirty-two years old when I met her, although I would imagine she was still being “carded” if she wanted to order an adult beverage, given her youthful appearance. She presented with depression that was not responding to medication, and as a result, she was referred to me by her primary care physician for treatment.
As is often the case, Holly was depressed because of her outlook on the world. Essentially, she was very self-deprecating in her thinking and saw her life as futile. To use her words, “There’s just nothing to look forward to anymore.” This last statement, especially with the word “anymore,” allowed me to peek under the hood, so to speak, to decipher what had sucked the hope out of young Holly’s life. What I learned I will never forget, because it’s just one more time I had to admit that this could very well have happened to me.
Holly had a brother, Tyler, seven years her junior. She adored Tyler as older siblings often do, especially when the difference in age disallows the development of a sibling rivalry. Instead, Holly conceived of herself as a junior mother to Tyler; he was her little boy. But one day when she was nineteen, she took her brother out for the day. They stopped first at a large department store, where Tyler temporarily became lost. Holly was horrified that something terrible had almost happened to Tyler on her watch! She would not be able to live with herself if she allowed something to happen to her “Baby Tyler.” Two hours later, Holly made an error in judgment behind the wheel of her vehicle, and twelve-year-old Tyler was killed by an approaching truck. Holly walked away physically unscathed but emotionally ruined for the foreseeable future. Tyler’s life had been snuffed out before he could even finish middle school, and it was all her fault. What could anyone say or do to help Holly overcome depression twelve years later, when she was still burdened by the realization that “I killed my favorite person in the world”? To me, it was little wonder that the antidepressants were ineffective—they don’t have a pill to remove the guilt of killing your little brother. Again, I will return to Holly’s story later in this chapter.
Elizabeth’s Story
Elizabeth is the grandmother every kid loves. Thoughtful, attentive, affirming, generous—she scores straight A’s across the board. But as awesome as Elizabeth is now as “grandma,” that’s how poor she was as a mother. Elizabeth was a “raging alcoholic” by her own words and “a horrible drunk” in the words of her oldest living son, Samuel. Samuel had an older sister, Joy, who fell victim to a drug overdose in her late adolescence. Both Samuel and Elizabeth blame the latter for Joy’s death, especially because Elizabeth was not much of a force in her children’s upbringing. She was too drunk to be a parent.
Elizabeth wasn’t always a drinker. Her alcohol abuse began shortly after her husband Ted died in a freak construction accident when the kids were nine and five. Raising two young children was a very difficult task for a young and freshly widowed homemaker. Elizabeth struggled with the unending demands of being the primary caregiver. When Ted died, there was a settlement, not enough to retire on, but enough for Elizabeth to avoid the prospect of having to work, at least for a while. Besides, her friends reminded her it was better for her kids if she stayed home with them, as they were already devastated by the loss of one parent. Losing her also was inconceivable, yet lose her they did, at least figuratively. Elizabeth hid her sadness and fear in an ever-present bottle of Absolut. She liked that vodka didn’t make her sick, and from her standpoint, it was undetectable to the kids because there wasn’t a strong scent of alcohol.
What there was instead was a self-absorbed, “self-piteous mother” with a lightning quick rage and a bitterness that penetrated any and all of her children’s defenses. There were legions of broken promises, embarrassing bouts of holiday drunkenness, and the prospects of a passed-out mother on the family couch with the TV blaring and nothing cooking, at the end of a school day. Not exactly Donna Reed. The kids would talk about their two lives—the one “before Dad died” and the “disaster that followed” with Mom at the helm, each day looking forward to school and sleep, as they were the places that mom’s ugly behavior could not penetrate, or at least not usually. There were times she showed up at school, half in the bag, with a lunch box or homework assignment in hand, something inadvertently left at home. The children were left with the ensuing public humiliation and the fear that the other kids would tease about “your mother, the drunk.” The kids, as is often the case, traveled in their different directions: Joy turned to drugs, while Samuel became a basketball fanatic.
Elizabeth continued to drink heavily, but when seventeen-year-old Joy’s accidental overdose resulted in death, things deteriorated rapidly. Elizabeth indulged in self-pity—life had taken two of her family members through no fault of her own. She was pulled over for two DUIs in six months. The second time prompted the judge to take decisive action—she was deprived of a driver’s license, placed in jail for one month, and given probation for a year, along with court-ordered treatment (following a substance abuse evaluation). Elizabeth complied with and successfully completed the latter and has been sober for the past eleven years due to a “religious” commitment to the AA program and its twelve steps and traditions. She is almost 180 degrees different in her attitudes and behaviors from where she was in her self-described ra
ce to self-destruction.
The grandparent role was much easier for Elizabeth, given that she was sober and could always return the kids to Samuel and his wife. Elizabeth’s newfound commitment to honesty and sobriety brought her to the fourth step in AA (a fearless moral inventory). She was able to remove her protective glasses in favor of a more realistic perspective on her role in Joy’s death. She concluded that she had abandoned her children when they needed her the most. She believes that had she responded to Ted’s death as a hands-on, loving, and reassuring mother instead of disappearing into a bottle, Joy might still be alive today.
Suicide was another option Elizabeth contemplated, especially when realizing that she had failed in the most important role she had ever played in her life—parenting the children to whom she had given birth, the people she loved the most. No matter what she did, Joy was gone, and to Elizabeth, escaping from the horrible guilt she felt through suicide appeared, at least at the time, to be a better option than always feeling like a failure.
But working with two people, one in her past (her AA sponsor, a retired minister) and one much more recent ally (me), afforded her a new perspective, which included the capacity and willingness to reengage with her family as a grandmother and as a mother to young adult children. But more on that later…
Mr. Avoidance Rears His Shameful Head Again
Moral injury complicates the healing process and makes it more difficult to traverse alone. Lacking moral injury, the grief-stricken may still become stuck in guilt—it hampers the grieving process and prevents people from letting go. In most of the stories up until this point, after finally confronting the trauma or the death, the clients usually accept that they have little to no responsibility for what happened to them or the deceased. Guilt usually results from thinking that you “should have, could have…known that this bad thing could be stopped, prevented, avoided, [or] changed” and that in the end what you did was bad. Without moral injury, guilt stems from a perceived violation of your own moral code, not bad behavior.46
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