#71 Anticipatory grief, part one
It is interesting how divergent information can come together and bring a bit of clarity. A devastating medical diagnosis of a family member, the CoVid pandemic, and a William White blog post brought all these together for me and helped me see how interrelated we all truly are. Although our situations and circumstances may be very different, our human condition is very much the same.
In doing some research on coping with a terminal illness, I came across the book, Smiling through your tears: Anticipatory Grief by Harriet Hodges and Lois Krahn. At the same time, this blog post by William White arrived in my inbox discussing how families deal with a loved one involved in substance use: http://www.williamwhitepapers.com/blog/2014/01/anticipatory-grief-and-family-recovery.html As I studied the news. I found discussions on how we as a society are coping with CoVid 19.An underlying theme of grieving for something that has not yet happened emerged connecting these concepts and ideas.
Grief is often viewed as a response to the death of a loved one. But grief can be much more complicated and nuanced than the sadness we feel when someone dies. The grieving process can surround any loss or life change such as unemployment, military service, relocation, the end of a relationship, medical diagnoses, having a loved one involved in substance use, or coping with the effects of a pandemic.
As a society, many of us find ourselves grieving during CoVid, even if what we are grieving is not obvious and straightforward. Most of us have lost routines, connections and certainty about the future. This fearful anticipation is called “anticipatory grief.” We have a sense of unease that the world will never be the same with a lingering sense that the worst has not yet arrived.
Anticipatory grief begins the moment we hear the awful news. It is the rehearsal–the progressive letting go–that helps us prepare for the impending loss. It is a complex process of trying to anticipate what life will be like in the future. Life becomes a waiting game, sending us into a state of emotional limbo. The unpredictable timeline makes it hard to plan ahead and pace our emotional reserves in the face of this massive, unstoppable glacier of an unknown future. Flexing to adapt to constant change takes an enormous amount of energy.
In a recent blog, national recovery advocate, William White, stated “For families facing addiction of a family member, every unexpected absence, every late-night phone call and every knock on the door elicits images of injury and death. These feared tragedies are repeatedly visualized and experienced with each episode marking an increment of physical and emotional disengagement.”
Whether our uncertainty comes from the projected death of a loved one, the roller coaster of substance use, or planning for the unknown post pandemic “new normal,” anticipatory grief can be exhausting and difficult. Next week we discuss strategies for coping with anticipatory grief regardless of its source.
#70 hope in a time of covid
Waiting is hard. Lately, it seems that all we do is wait. We wait to see what our new CoVid reality will look like. We wait for the financial/employment ramifications of the shutdown. We wait to see our friends, family and neighbors again. We wait for the results of the upcoming election. We wait for it to seem like life isn’t on hold anymore. The uncertainty leaves us exhausted, weary and perhaps in despair.
How we handle the waiting depends at least in part in hope. Hope can mean various things. Hope can be a wish. “I hope it won’t rain today.” This hope indicates what we think should happen, even though we have no control. Hope can be an intention or motivation. “I hope I can complete this task.” This hope shows what we are working towards and believe we can accomplish. Hope gives us courage to keep going, protecting us from fear and anxiety. Hope gives us purpose and motivates us to go on. Hope shapes the way we live and the decisions we make. Lack of hope can cause us to feel stuck, unmotivated, and purposeless.
Currently, the world seems unstable and unpredictable. It is easy to become discouraged and fearful, feeling alone and isolated. Often people lose hope because they don’t think their situation will ever change or be different. They feel as if they have run out of options and there is no reason to keep trying.
As hard as it is for us to remain hopeful in this challenging time, it is especially important for those in recovery. During this time of quarantine and isolation, there has been an increase in substance use and mental health issues. Isolation, uncertainty, and lack of hope have had devastating effects on many in recovery. As a friend told me recently, “People in recovery are struggling right now. …The quarantine has caused a lot of relapses, even in strong people.”
So what can we do to assist our friends in recovery post quarantine? We can offer them hope. Hope is a powerful force in the recovery process. It is the belief that recovery is possible. The more hope a person has the more likely they are to begin and sustain recovery. If our friends in recovery have experienced a setback, we can encourage them that this is only a misstep and not a Grand Canyon fall back into addiction. We can be a positive force in their recovery by not giving up on them. Being with hopeful people, instills hope in those around them. We can help them recognize possibilities and steps forward that they may not have considered or can’t see them on their own. Our words and attitudes let them know we do not consider them to be beyond help. Even a simple smile, phone call or text can offer encouragement and strength. Recovery is possible and you can be a part of it. There is hope.
There is a widely held misconception about addiction to substances. Many believe that once a person becomes addicted, there is little hope for recovery and the obstacles to recovery are insurmountable with little likelihood of success.
Statistics do not support this idea. According to drugfree.org, there are an estimated 22 million people in the United States involved in substance misuse. It is estimated that there are more than 23 million people in recovery from substances. Other sources indicate that ten percent of American adults self-identify as being in long term recovery from substance use.
For those who have a family member or friend caught in addiction, the roller coaster of recovery is one of hope, relapse, disappointment, recovery; and then the cycle begins again. The ups and downs of this road make long-term recovery seem impossible. The behaviors often associated with substance use can be frustrating, disturbing, and infuriating for those around the person. The chemical changes in the brain associated with substance use can lead to personality changes -- life revolves around obtaining the substance. Recovery may seem hopeless, but the Institute of Drug Abuse tells us that addiction is a chronic relapsing disease in the same medical category as other chronic diseases such as diabetes or heart disease.
Just like diabetes and heat disease, substance use disorder is influenced by some genetic predispositions, environmental factors and lifestyle decisions. No one chooses to become addicted or to develop diabetes or heart disease, but lifestyle decisions can have long term, negative effects.
The treatment of any chronic disease begins with an accurate diagnosis, followed by research-based treatment and long-term follow-up and support. Successful treatment of chronic disease requires healthy lifestyle choices such as good nutrition, exercise, developing positive coping strategies and stress reduction as well as following the prescribed treatment plan. It may take time to find the most effective treatment for an individual. The treatment plan and medications may need to be adjusted to accommodate the patient’s individual needs and response.
Individuals treated for chronic disease know that environmental factors and personal choice may lead to setbacks. Returning to previous lifestyles do not contribute to successful treatment. New habits must be embraced. People treated for cardiovascular disease know returning to a high-fat diet and sedentary lifestyle may contribute to additional health risks. Diabetics know that food choices and lack of exercise affects weight gain and increased blood sugar. Those involved in substance use find that returning to the same environment contributes to recurring use, legal issues and negative health outcomes.
There is another misconception that the relapse rate for substance misuse is very high. Relapse is defined as the return of a disease or the signs and symptoms of a disease after a period of improvement. In reality, relapse rates for most chronic health issues are very similar. According to a 2014 study by the Journal of American Medical Associated, relapse rates for those with type 2 diabetes range from forty to sixty percent. Relapse rates for those with hypertension (high blood pressure) are between fifty and seventy percent. Surprisingly, relapse rates for those with substance use disorder are around forty to sixty percent as well.
Treatment for chronic disease is rarely a one-and-done episode. Success requires a commitment to follow treatment plans, engage in lifestyle change, and perseverance. With proper treatment and support, people with chronic illnesses can recover and lead fulfilling, productive lives. Treatment works. Recovery is possible.
#68 alicia's story of recovery
Stories are powerful tools to communicate and promote understanding, empathy, and connection. Today’s story of recovery and hope from those who have overcome addiction describes the journey of Alicia, a single woman in her early thirties. Alicia has been in recovery since October 5, 2016. She has six sisters, two brothers and her parents were married for 50 years before her father passed away in 2015. She experienced a lot of adversity in her life, beginning with abuse suffered at the hands of a relative. This trauma affected her deeply, causing her to make many bad decisions, crippling her self-esteem. She struggled with substance use through her twenties, experiencing rehab, detox, recovery housing, and homeless shelters multiple times.
In her first significant period of recovery, she quit using, drinking, and smoking cigarettes. She ran her first half marathon, had her first back surgery, and started college all within one year. She successfully completed three years of college, but the old demons resurrected with catastrophic results. She fell back into her former lifestyle and dropped out of school. She went into detox twice and later was arrested. For some people, arrest is a wake-up call that life needs to change, but not for Alicia. This was yet another episode of misery and hopelessness causing her to fall farther into despair. She did not know how to cope.
Her father died while she was in prison. She was released and running on a warrant when she unexpectedly reconnected with her family. They decided to support her unconditionally while she served nine months for a probation violation, and her life began to change. She was the first client to be accepted and complete the Gilead House program in Kokomo. She ran two half-marathons. She connected with the Quick Response Team in Tippecanoe County, and is now working as Certified Recovery Specialist here in White County. She returned to college and recently graduated with a bachelor’s degree in sociology with a concentration in criminal justice. She was accepted to graduate school to earn a Master’s degree in social work, which has always been her dream.
Her life has changed! She loves serving her community and has a passion for serving nonviolent drug offenders caught in the grip of the criminal justice system, advocating for them when they are unable to speak for themselves. The QRT has served as a springboard for what she will be doing in the future, and for that she is truly grateful.
Alicia’s story illustrates the difficulties of overcoming trauma, the cycle of substance use, the importance of continuing to reach out for help, and never giving up. Her life demonstrates the power of recovery, offering hope for those still in that lifestyle. For Alicia, her family, running marathons, the support of the Gilead House, and her passion to help others made the difference. Overcoming substance use is battle that is not easily won, but with treatment and support, recovery is possible! Thanks, Alicia for allowing us to share your story. For help recovering from substance use, please call the QRT at 765-490-0381.
Lynn Saylor is the AmeriCorps member working with the United Against Opioid Abuse Initiative alongside the White County United Way. She is a major facilitator of the United Council on Opioids serving White County and a regular contributor to local media.