00:00 Bettina M Brown, In the Rising Host Hello and welcome to In the Rising, a health and wellness podcast for those going through and those supporting those going through cancer. My name is Bettina Brown and I'm board certified in physical therapy, wound care and lymph edema. And you know, for me, cancer is very personal. It's affected my friends, my immediate and my not so immediate family. And therefore I created this podcast and fit after breast cancer.com to address the multiple dimensions of our lives during and after recovery. This podcast episode is going to come out the day after Memorial Day, which is the day we celebrate military personnel who've lost something and usually lost their lives in some sort of combat or even in non-combat times. The idea of memorial and the idea of memories really stuck with me this year. Also having an expectation, right? We don't have an expectation that we're going to have some sort of loss of that degree. And it made me wonder about what we lose in our day to day lives. And especially as we are going through an event, it can be a health event, it can be a major life event. There is some grief that can come along with that. And so today's podcast episode is really about a journey, a health crisis journey. How do we manage that grief? And so I really like this one quote that I'm going to share with you at the end of this podcast, but it stuck with me and I don't think it just has to relate to a cancer journey. What is really grief? Let's start off there. And when we think about grieving, we often think about losing a family member, losing a friend. We think about loss. How do we cope with that? And there are so many situations that can cause grief and death is not the only one. There's divorce, there's a change or loss in your perception, your physical ability, your function, your plans. There's grief among many things because we have a certain view and certain expectation of our life. There are of course many people, social workers, psychologists, counselors, therapists, of which I am not one. I am a life coach, but I'm not a counselor. I just want to put that out there. There's a lot of research and a lot of personnel who really help others cope with grief. And we're in that phase, we can wonder if we're coping correctly. And as a person who's worked with many clients going through all sorts of diagnoses and not just including cancer, not just including terminal diseases, disabilities, but grief is kind of goes hand in hand when you're working with as a physical therapist. Do you see so much loss of expectation, of function, of physical function and physical ability independence that there is grief involved with that? And often I'm asked, do other people feel this way? Are other people struggling with their own journey the same way that I am? It does take me a moment to think about, well, do we have a perception of what grief really should look like? There is a psychologist that really shares, and I have all this in the show notes, that no person responds to grief the same way and that is okay. The only true unhealthy grieving is if you're hurting yourself or you're hurting someone else. And so I really believe that opens up the span of what grief is, what grief can look like if we have that kind of permission slip, that as long as I'm not getting hurt or hurting someone else, it's expected to have these ups and downs. What does really grief look like? Well, Dr. Joanne Frederick, and I'll have her information, she's the author of Copology and she really explains grief as an extreme sadness. And this extreme sadness can show up in so many different ways. There is even verbal or physical aggression. And at first I thought, I've not come across that. And then I realized, yes, I did. I came across it when I myself was very frustrated in a certain time of my life that any question asked of me, I answered it with this like a brick wall. And I had to apologize many times. Like, I'm sorry that came out that way. But I was really not angry. I was expressing grief and a lack of control. And I was so grateful that there were people around me that really accepted and respected my way of exploding as best I can because I had to hold it together for my clients. But when it came to my family, I couldn't anymore. And so physical aggression can even be when people start going to the gym, that major life things happen. And suddenly that's when working out is just a huge thing. And you can usually tell when we're more in shape that we're either very, very happy with our gym routine or we're going through something. The other thing is reclusion or not spending time with other people. So isolation. And that has an ability to cope because you're not having to put a show on. You're not having to express yourself like you're happy, you're okay, you're going to make it. And you know, being around people takes a lot of work, takes a lot of energy to hold it together. And sometimes you just don't have it. And so it is nice to have that ability to isolate. On the other hand, if you're only in isolation, then you also don't have the ability to look at anything else, right? When we're only looking at our own problems, they get bigger and bigger and bigger. So the third one here I'm going to describe is crying spells where you're fine, you're fine and then boom, you're not. And crying for just the ability to not cope with everything that is happening. They also have the disappearance, which I think is reclusion. But sometimes people like literally just disappear. They don't come back out. They don't communicate. They don't text. They don't respond to anything, not even to wellness checks by family. And so they really just want to disappear from life and engaging in anything that brought them happiness or could possibly bring them into any memory of things that they have been encountering when they were not grieving. And so there's also, we hear about it, the five stages or the seven stages of grief. But what I've read a lot about, and I believe myself from observing and having been there, is sometimes when we talk about stages that the terminology, the words we use are maybe not the best. Well, I'm going through this stage. So the next stage is this and then I should be fine. And that's not how that is. And the stages are really more like very fluid. It's not like you're baking a cake. You do this, this and this. And then your final end product is when you're not in grief. The final end product can be in a few months. It can be in several years. It can be never. That you're always in some form of grief, but that you're still able to manage your life. And so stages give it, make it easier to have a context for discussion. It makes it easier to have a podcast, but it does not mean that you linger in one place. It really does mean that you're moving in and out, kind of like border states. You're in one state, then the other, and then another one. The big thing is that there's movement and not stagnation because you can have that sadness, but not necessarily a deep depression when you're moving in and out. So what are some stages of grief? Well, for one shock and sometimes this first, what they call first stage. And again, I'm going to use that term loosely is that you don't even have the ability to comprehend what's happening or what's being said. How can this even be a concern? How can this loss, how can this diagnosis even really be happening? I must be in a nightmare. I must be in a dream. I'm going to pinch myself and wake up. I can't process it. And a lot of times there are no emotions with that time because of the inability to process what's happening. Then there is a denial for a lot of people. And that denial can just be that, no, this is not really what I want. This is not what I expect. This is not what this looks like. This is not what my life looks like. And then it moves on to anger. And anger is almost a breakthrough. I think we give anger a bad rap that if you're an angry person, it's because you're not nice. You're an angry person because you can't cope. You're an angry person because you're blaming. Even though those things may be part of anger in so many areas of life, anger is really a step through from having no control to realizing that you have very little control over many things but able to move past that. Anger if you're staying there and we've all met, many of us have met people who are just angry all the time. That's not movement forward either. That's having more of a victim lifestyle, a victim mentality. There's a lot of power in that. Angry with everything that anything ever happened. But anger goes from not having any feeling into having some feeling and being able to move through. So anger is actually, if you talk about vibrations, is actually a higher vibration that you're towards going through grief. And I'm going to pause there because so often you'll hear people say, well, when you're done grieving, you don't have to be done. It always has a journey. But a journey does involve movement and moving forward. And so to move on through that anger and to move on, there are other things that we can expect and one is bargaining. And this is often when we will bargain with people, bargain with ourselves, bargain with a higher power. If you will do this, especially if we have a loss of something that is not permanent. And sometimes our health is one of those. We may not have a terminal diagnosis, but we have to have an amputation. We may not have a terminal diagnosis, but we're not able to run the race we've been pairing for for six months. There are so many things. Divorce is one of them. So bargaining is often that phase when we realize if we just give some hope and give that power to someone or something more powerful than us, maybe we can move through. And then it goes on to accepting and hope. Acceptance is not that you're okay with it. Acceptance never means that you're fine with whatever happened, that you're, oh, no big deal. This person passed away. Oh, no big deal. This is a diagnosis. It is accepting. You're no longer in shock. You are accepting what is and now you are processing how to deal with what is and you're processing how your life can be different and yet still be good and making new goals, making new decisions and having a different outlook on that. Sometimes in their stages, they do mention depression, but I also wanted to emphasize as much readings I've done, depression has not always been consistent. Depression is not severe sadness. Depression is a wallowing of no hope and that no hope is really coming. You can be extremely sad for a very long time and still not be depressed. And this is where having outside help can be really helpful as well. And so what are healthy ways to navigate that? Again, healthy means it's personal and that you're not hurting yourself or hurting others. And one big thing is to give yourself permission to sit with those feelings. And I think this is one of the hardest things to do that I've witnessed and that I have to be personal about myself. Sitting with feelings. We like to move on past feelings, right? We like to distract ourselves and we can do that with friends. We can do it with eating. We can do it even with excessive amount of workouts. We can do it with anything that can be a distraction to actually stopping to feel. And you can't deal with what you don't feel. And feeling doesn't feel good. And so a lot of times giving yourself that permission, like it's okay to feel this way. It's okay to not be happy all the time. It's okay to not answer that you're fine when someone asks how you are. It's okay to roll your eyes when you know they don't really care. And they're just saying the things to say the things. You're okay with that. And when you are doing that, you're giving yourself permission. You're giving yourself compassion. And you're giving yourself some acceptance for where you are. And ultimately, no one can give you that the way that you can give that to yourself. Another thing is you can develop a helpful response to yourself and to others. Like well, of course, you know, how are you feeling sad? Of course I feel sad. Or repeating to yourself, yes, I feel sad, but I'm not depressed. I'm okay to feel sad. I'm allowed to feel this way. I am giving myself that permission. And the other thing that I'd like to share is considering another perspective. So processing feelings is sometimes something we go through for the rest of our lives. There's no way that many people who've ever been through a medical issue are just one and done. I've met a few, but there has been some processing or they've really gone through an intense personal search and really dug through the depths of their own, you know, night of the soul, deep, dark soul night and come on the other side that every perspective is now different. But things mean different things to you at different times of your life. 20, for example, may not have the same effect on you as a divorce when you're 65 and having a cancer diagnosis when you're 85 may not feel the same way as a cancer diagnosis when you're 20. So acknowledging that where you are in life and what your goals are pertaining to that perspective often helps look at things. What have I done? What am I willing to do? What can I do with this? How is what I'm going through going to be used meaningfully for other people? And a meaningful activity is often what people go to. Almost everything that we go through from anyone from Holocaust survivors to people have gone through war, people have gone through some major things, they put meaning to it. And if someone can learn from this and if it can create a change in a community, if it may change the trajectory of war, then it is important and it gives meaning to that uneasy feeling. It gives meaning to that experience. It gives meaning to that suffering. And that changes the human experience. And so when you're having, for example, as this show, you know, health and wellness, how do you find meaning in your life after said diagnosis? How do you find meaning after a change in your function? How do you find meaning before, during, and after that grief? So as a wrap up, there are stages in quotes, air quotes to grieving, but that doesn't mean it's just one to two to three. It's a very fluid thing. And another main point is that you can always give yourself permission to move at your pace and find your own meaning and find your own experience of value. And everyone's experience is different. Even if it's the same age, same diagnosis, almost the same demographics, your experience is yours. And having some self-compassion really makes such a difference for your journey and your own experience. And we all learn from each other. And in that way, we can grow and build one another up. So what was that quote? To spare myself from grief at all costs can be achieved only at the price of total detachment, which excludes the ability to experience happiness. You have joy and sadness and they come together. And you have immense happiness because it fills a place where sadness would be. They come together and knowing that you're in one or in the other allows you to really have that real happiness. And that is really what the human experience is all about. So thanks again for listening on in and I welcome you to join my email list. I also welcome you to ask me questions or if you feel like you have a powerful story and you want to be on the podcast, go ahead and reach out to me all the information's below. And until next time, let's keep building one another up.