What Abi Taught Us

by Lucy Hone

  Among these prisoners, other common ways of coping were humour, faith and spirituality, the presence of role models, a willingness to help others and an optimistic outlook. The POWs also worked hard to maintain physical fitness, despite the limitations of their cells. This, said the researchers, boosted their self-esteem and mental toughness.

  I’d first come across Charney’s work and the notion and practice of resilience training at the University of Pennsylvania, where our lead instructor on the topic was Karen Reivich. Co-director of the Penn Resiliency Project, Reivich had several years of experience developing resilience training programmes for schools and corporate organisations, and had been awarded the contract to train the entire US Army in the psychological skills of resilience, making them as psychologically fit as they were physically fit. She taught me three fundamental truths about resilience: 1) most people are resilient; 2) resilience requires very ordinary processes; and 3) these processes can be taught and learned.

  Later, after Abi died, she wrote to me: ‘So many of the interventions I teach are not exactly rocket science . . . More a matter of making it your intention to put your attention here rather than there.’4 Her words gave me hope. I reckoned I could choose to put my attention on the good things I still had in life, on nurturing the relationships with those close to me, on accepting what I could change and what I could not, on using my strengths to assist with recovery.

  This book therefore looks at the types of personal assets and resources (promotive and protective factors in psychological terms) that have been shown to predict good outcomes in resilience studies, and examines their usefulness in a new context—that of grieving. It also asks a number of questions. What helps people cope during bereavement? Do some people manage to recover faster than others? Which ways of acting and thinking help us get through the loss of a loved one, and which hold us back? How long does grief have to last: is there a fixed time frame? Is it possible to grieve too quickly and is that a sign of denial? Does it all come down to individual differences, or might some of these strategies prove helpful for numerous people going through grief ?

  ‘SO MANY OF THE INTERVENTIONS I TEACH ARE NOT EXACTLY ROCKET SCIENCE . . . MORE A MATTER OF MAKING IT YOUR INTENTION TO PUT YOUR ATTENTION HERE RATHER THAN THERE.’ KAREN REIVICH

  I must confess that when I first started writing this book I was sceptical (even within myself) about the notion of resilient grieving—was it really possible to expedite the grief process by employing certain cognitive and behavioural strategies? Were the evidence-based tools we use in resilience training useful in the context of bereavement? Or was I deluded, heading for a fall? Was I, in fact, just demonstrating one of Kübler-Ross’s famous five stages of grief—that of denial? I hesitated and pondered, but my understanding of humans’ extraordinary capacity to bounce back from a wide range of traumas (natural disasters, war, imprisonment) convinced me to try. Who was to say that the same resilience skills and recovery strategies cannot be applied to life after loss?

  Then I found George Bonanno and a new breed of research academics, all of whom are starting to explore what resilience looks like in the context of bereavement. Similarly, Thomas Attig assured me that while our initial reactions to grief are passive and somewhat beyond our control, we are not entirely helpless in grief: grieving is in fact filled with choice.5 These researchers’ findings, gathered via structured interviews, and cross-sectional and longitudinal survey data, were compelling.

  Over the course of 20 years of research, Bonanno, a clinical psychologist at Columbia University and author of The Other Side of Sadness: What the new science of bereavement tells us about life after loss, has discovered that coping well in the face of bereavement is much more common than bereavement researchers have previously reported. His studies show that most people bounce back from bereavement in much the same way they do from other adverse life experiences (child poverty, war, natural disasters, terrorism).

  His studies also confirm that there is a resilient type of person. ‘We consistently find specific psychological characteristics among people who cope well during bereavement. One such characteristic is the ability to adjust to the shifting demands of different situations. This is a kind of behavioural flexibility . . . Every stress and adversity challenges us in particular ways. The types of struggles people confront when they lose a loved one to a graphic or violent death are different from the stresses that arise when a loved one succumbs to a prolonged illness. Dealing with loss is different from coping with other types of violent or dangerous trauma, like surviving a hurricane or tsunami. By and large, the people who deal best with these different situations are those who can do what it takes to get through the event.’6

  Those words sum up my attitude to resilience and surviving bereavement—for me, it’s been a matter of doing what I can to get through each hour, day, week, month and year. That’s the mission synopsis right there.

  By applying the same mixed-method scientific methodology that the likes of Masten, Southwick and Charney, and Reivich have applied to other types of trauma, Bonanno and his colleagues have challenged some of the traditional myths about bereavement. For example, grief experts had previously assumed that expressing emotional pain was an essential part of bereavement; that anyone not doing so (which they term absent grief ) was demonstrating denial, and that the failure to express this pain would result in what they termed a delayed grief reaction further down the track.

  IT’S BEEN A MATTER OF DOING WHAT I CAN TO GET THROUGH EACH HOUR, DAY, WEEK, MONTH AND YEAR.

  One of Bonanno’s research team’s most consistent findings is that we don’t all have to travel through the various stages of grief; nor do we have to necessarily work through several tasks of mourning, as many grief theorists have suggested. Furthermore, there is no robust scientific study that has demonstrated the existence of delayed grief. They found ‘people who were well adjusted after a loss were almost always healthy years later. Delayed grief simply did not occur.’7 This provided me with a vitally important piece in my own jigsaw puzzle of grief.

  Similarly, Bonanno’s findings on the concept of ‘grief work’ (a phrase originally coined by Sigmund Freud in 1917 and picked up by Erich Lindemann in the 1940s) exposed the limitations of that theory. ‘As researchers began to devote more attention to the bereavement process . . . it became apparent that, despite the near unanimity with which mental health professionals endorsed the grief work perspective, there was a surprising lack of empirical support for such a view,’ he explained in 2004.8 Instead, Bonanno and his colleagues suggest there are three common responses to bereavement: some bereaved individuals experience chronic grief (the loss overwhelms them and they seriously struggle, sometimes for years, to return to normal functioning); some experience a gradual recovery (having initially suffered and displayed symptoms of depression or post-traumatic stress disorder, they gradually, over several months, return to pre-event functioning); but most individuals are resilient in the face of grief in that they maintain relatively stable, healthy levels of psychological and physical functioning. Resilient individuals may experience several weeks of sporadic preoccupation or restless sleep but they ‘generally exhibit a stable trajectory of healthy functioning across time, as well as the capacity for generative experiences and positive emotions’.9

  Because bereavement research has historically been dominated by studies involving individuals experiencing acute and chronic grief (known among health professionals as ‘complicated grief ’), such reactions came to be regarded as the norm. ‘Bereavement theorists have been highly sceptical about individuals who do not show pronounced distress reactions or who display positive emotions following loss, assuming that such individuals are rare and suffer from pathological or dysfunctional forms of absent grief,’ writes Bonanno. In fact, having reviewed all the available research, his studies show that ‘the vast majority’ maintain healthy functioning. For example, several different studies following bereaved individuals over time have esti
mated that chronic grief occurs in just 10–15 per cent of individuals,10 whereas bereaved individuals demonstrating resilience (relatively low levels of depression or distress) have consistently approached or exceeded 50 per cent of the sample,11 and 60 per cent of bereaved study participants have consistently reported high life satisfaction over the years.12

  This is not to say that any of us is immune to grief. I still have afternoons when all I can do is retreat to bed and let myself go in the knowledge that having to cope with Abi’s loss is not okay. It’s not okay that we have to endure this, and it’s not okay that she had to die and miss all the wonderful moments of her life—or even the crappy ones too. One single moment of motorised madness should not have robbed our beautiful girls of decades of living. That’s simply not right or fair. But I’m not angry—I don’t see the point. Mostly, I still function and, I’m willing to admit, this is something of a relief. I’m surprised how quickly Trevor, the boys and I have managed to bounce back from the trauma of Abi’s sudden and utterly unexpected death, and how readily we’ve managed to juggle sadness and continued living, and mostly maintained full psychological and physical functioning. Even after the death of a child. Discovering that there are plenty of others like us has made me feel less as if we’re unfeeling or freakish. Reading accounts of resilient grievers who have continued to suffer negative emotions, misery and longing for their loved ones, but done so while carrying on with full and rewarding lives, somehow makes it feel more okay to act this way.

  Because it’s so important, I’m going to repeat this one more time. Studies show most people make a good recovery from the psychological and social effects of significant disasters, including bereavement. They also show resilience requires very ordinary processes. Karen Reivich describes these processes as a stew, containing lots of different ingredients, some of which we will have in plentiful supply, some we may be running low on. We may not like the taste of some of them; others will immediately appeal to us. I like to think of it as a jigsaw puzzle, but, ultimately, it’s up to us to find the things that help us process what’s happened and relearn how to live in the world we are faced with.

  10 TOOLS TO BUILD RESILIENCE

  Dennis Charney and Steve Southwick are among the leading world experts in the neurobiology and treatment of mood and anxiety disorders, as well as the neurobiology of resilience to stress. They have found that psychological stress alters brain functions; certain identified key factors are related to resilience; and it is very possible to train yourself to be more resilient. They have identified the following 10 tools for promoting resilience.

  1. Adopt a positive attitude:

  • Optimism is strongly related to resilience (‘sounds trivial, but it’s really hard’).

  • Optimism is in part genetic (‘but genes are not destiny and you can make yourself more optimistic’).

  • Optimism can be learned (via tools such as cognitive behavioural therapy).

  • Unbridled and unrealistic optimism (aka ‘Pollyanna optimism’) is not good and gets you in trouble.

  • A truly optimistic person confronts the brutal facts of their current reality, accurately appraises the trauma and situation, but simultaneously has the confidence that they will prevail in the end, regardless of the difficulties.

  2. Think flexibly:

  • Cognitive flexibility through cognitive reappraisal is strongly related to resilience.

  • Traumatic experiences can be re-evaluated by altering the event’s perceived value and meaningfulness.

  • Benefits can be derived from stress and trauma: it is possible to reframe, assimilate, accept and recover; these skills can be learned.

  • Failure is an essential ingredient for growth.

  3. Embrace a personal moral compass:

  • Developing a set of core beliefs that very few things can shatter is strongly related to resilience.

  • For many this takes the form of faith in conjunction with strong religious and/or spiritual beliefs, but it doesn’t have to be so.

  • Altruism (giving to others) has been strongly related to resilience.

  • Having a survivor’s mission is also strongly related.

  4. Find a resilient role model:

  • Role models are important; they can be found in your own life but you don’t have to know them (e.g. Viktor Frankl, Nelson Mandela).

  • Imitation is a very powerful mode of learning.

  5. Face your fears:

  • Fear is a normal part of life and can be used as a guide; facing your fears can increase your self-esteem.

  • Learn and practise skills necessary to move through fear.

  6. Develop active coping skills:

  • Resilient individuals use active, rather than passive, coping skills.

  • Minimise your appraisal of the stressor, create positive statements about yourself, and actively seek support from others.

  7. Establish and nurture a supportive social network:

  • Very few can ‘go it alone’; humans need a safety net during times of stress.

  • Develop your own kind of ‘tap code’.

  • Considerable emotional strength accrues from close relationships with people and organisations.

  8. Attend to physical wellbeing:

  • Physical exercise has positive effects on physical hardiness, mood, and improves self-esteem.

  9. Train regularly and rigorously in multiple areas:

  • Change requires systematic and disciplined activity.

  • Concentrate on training in multiple areas: emotional intelligence, moral integrity, physical endurance.

  10. Recognise, utilise and foster signature strengths:

  • Learn to recognise your character strengths and engage them to deal with difficult and stressful situations.

  Adapted from D. Charney, ‘The Resilience Prescription’.13

  Chapter 4

  Accept the loss has occurred

  FIVE SHORT WORDS—ACCEPT THE loss has occurred: so easy to write, so hard to do. I wrote the title of this chapter and then just stared at the words for an eternity. How can I tell you simply to ‘accept the loss has occurred’, when it is the greatest challenge of all?

  Accepting that the loss has occurred is recognised by many bereavement researchers, grief counsellors and therapists as an essential step in successful grieving. William Worden, co-principal investigator for Harvard’s Child Bereavement Study, and whose book, Grief Counseling and Grief Therapy: A handbook for the mental health practitioner, is viewed by many as the bible for complicated grief, regards accepting the reality of the loss as one of the essential tasks of mourning. The others are to process grief ’s pain; to adjust to a world without the deceased; and to find an enduring connection with the deceased while simultaneously embracing a new life. All of these would become familiar to me in time, but accepting the reality of the loss was the first step.

  After Abi died, we worked very hard on accepting as quickly as we could that this terrible thing had happened. That was my way: I regarded accepting the loss as the first step, not out of knowledge of any particular grief theory, but intuitively. It was my logical first big step in survival. This doesn’t mean it will be your first step. For some it’s plainly obvious; for others it takes time. But, accepting the loss has occurred is a necessary step in adapting to it. Accept that it is irreversible: that no amount of wishing, wanting, urging or bargaining will change the outcome. This terrible thing has happened, I told myself over and over. To me, to us, to her. She is Dead. It is Done. And there’s nothing I can do.

  I remember the discussion Trevor and I had one week after the girls died. We sat on the rocky wall, just above the beach, and looked out to sea, wondering what to do, what to say, how to go on living in our hateful, hopeless new world.

  It wouldn’t have been any different if she’d died of cancer, I said to him. We’d be in just the same place right now, bereft and full of desolate, profound and overwhelming sadness. In fact, we
could argue, that would have been worse. Watching her die, willing her to live, hanging on to hope and watching it slip away—I wouldn’t choose that.

  But then I wouldn’t choose this—the sudden, abrupt wrenching of life—either.

  That’s the point, though. In death there is no choice. Death doesn’t discriminate between good and bad, young and old, rich and poor. It is entirely random. We don’t get to choose between sudden or slow, nor when it occurs, nor how.

  And in my mind, pondering why, or how, was a waste of precious energy, which was suddenly in very short supply. That was energy we were going to need to get through each day, to maintain the uphill struggle for the weeks, months and no doubt years to come. So, taking Reivich’s words literally, I decided not to focus my attention on the mechanisms of their deaths—how Abi, Ella and Sally died, or, for that matter, how their deaths might have been avoided. Right now, accepting the loss had occurred, and that we had to move forward throughout the rest of our lives without Abi, was going to require every ounce of energy we would have left. I’m fortunate that Trevor could do the same.

  DEATH DOESN’T DISCRIMINATE BETWEEN GOOD AND BAD, YOUNG AND OLD, RICH AND POOR. IT IS ENTIRELY RANDOM.

  Very occasionally I’ve had to stop myself from heading down the ‘what ifs’ rabbit warren. Researchers call this very common practice ‘bargaining’. What if we hadn’t received the phone call offering her a ride that day? What if I’d stopped her from going? What if I hadn’t planned that weekend away at Ohau? What if I had never wanted to go bloody mountain biking and we had just stayed at home (as Ed and Trevor wanted)? What if anything had delayed them even just for a second? Usually, I’ll get this far, mostly just two questions in, before the futility strikes me. ‘What ifs’ are pointless, irrelevant and, above all, cruel. Stop questioning why: there are no answers. They eat up vital energy on a fruitless endeavour. There were a thousand opportunities for there to have been a different outcome from that car journey, a different end to that fateful day, but none of them eventuated. Their deaths are real. The accident really happened. Those three beautiful girls are not coming back to us again. Ever. Get this fact into your thick skull as quickly as you can, I told myself. Do not waste time, or energy, wondering what could have happened differently. What’s happened has happened. Get on with it, accept they have gone, and work out a way of dealing with that reality so that it doesn’t cost you the rest of your family life.